End effector with implantable layer

- Ethicon LLC

An end effector for stapling patient tissue is disclosed. The end effector comprises a frame comprising a proximal end and a distal end, a plurality of staples, a firing system configured to implant the staples into the patient tissue, an implantable layer comprising a tissue-contacting surface and a support surface, and an array of securement members extending above and below the support surface of the implantable layer. The securement members are detached from the frame concurrently with the firing system being actuated to implant the staples.

Skip to: Description  ·  Claims  ·  References Cited  · Patent History  ·  Patent History
Description
CROSS-REFERENCE TO RELATED APPLICATIONS

This non-provisional patent application is a continuation application claiming priority under 35 U.S.C. § 120 to U.S. patent application Ser. No. 13/097,856, entitled STAPLE CARTRIDGE COMPRISING STAPLES POSITIONED WITHIN A COMPRESSIBLE PORTION THEREOF, filed Apr. 29, 2011, now U.S. Patent Application Publication No. 2012/0080336, which is a continuation-in-part application under 35 U.S.C. § 120 of U.S. patent application Ser. No. 12/894,369, entitled IMPLANTABLE FASTENER CARTRIDGE COMPRISING A SUPPORT RETAINER, filed on Sep. 30, 2010, now U.S. Patent Application Publication No. 2012/0080344, the entire disclosures of which are hereby incorporated by reference herein.

This non-provisional patent application is a continuation application claiming priority under 35 U.S.C. § 120 to U.S. patent application Ser. No. 13/242,029, entitled SURGICAL STAPLER WITH FLOATING ANVIL, filed Sep. 23, 2011, which issued on Nov. 25, 2014 as U.S. Pat. No. 8,893,949, which is a continuation-in-part application under 35 U.S.C. § 120 of U.S. patent application Ser. No. 12/894,369, entitled IMPLANTABLE FASTENER CARTRIDGE COMPRISING A SUPPORT RETAINER, filed on Sep. 30, 2010, now U.S. Patent Application Publication No. 2012/0080344, the entire disclosures of which are hereby incorporated by reference herein.

BACKGROUND

Technical Field

The present invention relates to surgical instruments and, in various embodiments, to surgical cutting and stapling instruments and staple cartridges therefor that are designed to cut and staple tissue.

Background

Endoscopic surgical instruments are often preferred over traditional open surgical devices since a smaller incision tends to reduce the post-operative recovery time and complications. Consequently, significant development has gone into a range of endoscopic surgical instruments that are suitable for precise placement of a distal end effector at a desired surgical site through a cannula of a trocar. These distal end effectors engage the tissue in a number of ways to achieve a diagnostic or therapeutic effect (e.g., endocutter, grasper, cutter, staplers, clip applier, access device, drug/gene therapy delivery device, and energy device using ultrasound, RF, laser, etc.).

In many endoscopic surgical applications, it is desirable to employ end effectors that are only as large as necessary to complete a particular surgical procedure. Smaller end effectors provide better visualization of the surgical site. Smaller end effectors also allow for better access and manipulation in tight spaces. Designers of such end effectors face many challenges when trying to develop small end effectors. The ability to manufacture small end effectors and, more particularly, small endocutters that are designed to cut and staple tissue is hampered by the magnitude of the actuation forces that are generally required to form lines of staples and cut tissue. Such actuation forces can also vary with the thickness and composition of the tissue being treated. For example, larger actuation forces are commonly required to cut and staple thick tissues. Whereas, the magnitude of the actuation forces required to cut and staple thinner tissues in general are smaller. Thus, many existing endocutters typically employ robust anvil closure systems and staple driving systems that are configured to accommodate a specific range of tissue thicknesses. Such devices, however, are often not well-suited for treating thinner tissues.

Prior endocutter devices also generally cut the tissue as the staples are driven and formed in the tissue on each side of the cut. While such devices are very effective for those procedures that require the tissue to be cut and fastened, they do not provide the surgeon with the option of installing fasteners without cutting tissue. Likewise, while various forms of articulating endocutters have been developed to improve access, the components generally employed in such devices must be substantial enough to accommodate structures that can generate and transmit sufficient firing and closure forces to the end effector from the handle of the device. Thus, such end effectors are often too large to effectively access tight spaces in the body.

Accordingly, there is a need for surgical cutting and stapling instruments and staple cartridge arrangements that address many of the challenges discussed above.

The foregoing discussion is intended only to illustrate some of the shortcomings present in the field of the invention at the time, and should not be taken as a disavowal of claim scope.

BRIEF DESCRIPTION OF DRAWINGS

The above-mentioned and other features and advantages of this invention, and the manner of attaining them, will become more apparent and the invention itself will be better understood by reference to the following description of embodiments of the invention taken in conjunction with the accompanying drawings, wherein:

FIG. 1 is a cross-sectional view of a surgical instrument embodiment of the present invention;

FIG. 1A is a perspective view of one embodiment of an implantable staple cartridge of the present invention;

FIGS. 1B-1E illustrate portions of an end effector of various embodiments of the present invention clamping and stapling tissue with an implantable staple cartridge embodiment of the present invention;

FIG. 2 is an exploded assembly view of an end effector embodiment and a portion of a surgical stapling instrument embodiment of the present invention shown in cross-section;

FIG. 3 is a side elevational view of an anvil embodiment of the present invention;

FIG. 4 is a is a cross-sectional view of a portion of the handle assembly depicted in FIG. 1;

FIG. 5 is a partial cross-sectional view of the handle assembly of FIG. 1 taken along line 5-5 in FIG. 1;

FIG. 6 is a perspective view of a portion of firing transmission embodiment of the present invention;

FIG. 7 is a partial cross-sectional view of the handle assembly of FIG. 1 taken along line 7-7 in FIG. 1;

FIG. 8 is a partial cross-sectional view of a portion of the handle assembly of FIG. 7 taken along line 8-8 in FIG. 7;

FIG. 9 is a cross-sectional view of a surgical instrument embodiment of the present invention after an end effector has been coupled to a spine portion of the surgical instrument and prior to being locked thereto;

FIG. 9A is an enlarged view of the end effector and a portion of the surgical instrument of FIG. 10;

FIG. 10 is a cross-sectional view of the surgical instrument of FIG. 9 after the end effector has been locked to the spine portion of the surgical instrument;

FIG. 10A is an enlarged view of the end effector and a portion of the surgical instrument of FIG. 10;

FIG. 11 is a cross-sectional view of the surgical instrument of FIGS. 9 and 10 after the first firing adapter has been advanced to the beginning of the clamping ramp portions of the anvil;

FIG. 11A is an enlarged view of the end effector and a portion of the surgical instrument of FIG. 11 with tissue received between the anvil and staple cartridge thereof;

FIG. 12 is a is a cross-sectional view of the surgical instrument of FIGS. 9-11 after the first firing adapter has been advanced over the clamping ramp portions of the anvil;

FIG. 12A is an enlarged view of the end effector and a portion of the surgical instrument of FIG. 12;

FIG. 13 is a cross-sectional view of the surgical instrument of FIGS. 9-12 after the first firing adapter has been advanced over the staple forming ramp to fully form the staples within the implantable staple cartridge;

FIG. 13A is an enlarged view of the end effector and a portion of the surgical instrument of FIG. 13;

FIG. 14 is a cross-sectional view of the surgical instrument of FIGS. 9-13 after the first firing adapter has been advanced over the staple forming ramp to fully form the staples within the implantable staple cartridge and after the knife bar has been longitudinally advanced through the end effector;

FIG. 14A is an enlarged view of the end effector and a portion of the surgical instrument of FIG. 14;

FIG. 15 is an exploded view of another end effector embodiment of the present invention with a portion of the spine member of a surgical instrument embodiment of the present invention shown in cross-section;

FIG. 16 is a partial cross-sectional view of the end effector embodiment of FIG. 15 in the open position and attached to the surgical instrument embodiment;

FIG. 17 is another partial cross-sectional view of the end effector embodiment of FIGS. 15 and 16 in the fully clamped position;

FIG. 18 is another partial cross-sectional view of the end effector embodiment of FIGS. 15-17 in the fully fired position and prior to advancement of the distal knife member;

FIG. 19 is another partial cross-sectional view of the end effector embodiment of FIGS. 15-18 in the fully fired position and after complete advancement of the distal knife member;

FIG. 20 is a cross-sectional view of a portion of another handle assembly embodiment of the present invention;

FIG. 21 is a partial cross-sectional view of a portion of the handle assembly of FIG. 20 taken along line 21-21 in FIG. 20;

FIG. 22 is a partial cross-sectional view of a portion of the handle assembly of FIG. 20 taken along line 22-22 in FIG. 20;

FIG. 23 is a partial cross-sectional view of a portion of the handle assembly of FIG. 20 taken along line 23-23 in FIG. 20;

FIG. 24 is a cross-sectional view of a portion of another handle assembly embodiment of the present invention;

FIG. 25 is a partial cross-sectional side view of another end effector embodiment of the present invention coupled to a portion of a surgical instrument embodiment of the present invention with the end effector supporting a surgical staple cartridge embodiment of the present invention and with the anvil thereof in an open position;

FIG. 26 is another partial cross-sectional side view of the end effector of FIG. 25 in a closed position;

FIG. 27 is another partial cross-sectional side view of the end effector of FIGS. 25 and 26 as the knife bar is starting to advance through the end effector;

FIG. 28 is another partial cross-sectional side view of the end effector of FIGS. 25-27 with the knife bar partially advanced therethrough;

FIG. 29 is a partial cross-sectional side view of another end effector embodiment of the present invention coupled to a portion of a surgical instrument embodiment of the present invention with the end effector supporting another surgical staple cartridge embodiment of the present invention and with the anvil thereof in an open position;

FIG. 30 is another partial cross-sectional side view of the end effector of FIG. 29 with the knife bar partially advanced therethrough;

FIG. 31 is a cross-sectional view of another surgical instrument embodiment of the present invention with the anvil of the end effector thereof in an open position;

FIG. 32 is an exploded assembly view of the end effector embodiment and a portion of the surgical stapling instrument embodiment of FIG. 31 shown in cross-section;

FIG. 33 is a top view of the end effector and a portion of the elongated shaft assembly of the surgical instrument of FIG. 31 with portions thereof shown in cross-section taken along line 33-33 in FIG. 31;

FIG. 34 is a top view of the end effector and a portion of the elongated shaft assembly of the surgical instrument of FIG. 31 with portions thereof shown in cross-section;

FIG. 35 is another top view of the end effector and a portion of the elongated shaft assembly of the surgical instrument of FIG. 31 with the end effector in articulated orientation and with the end effector in an open position;

FIG. 36 is another top view of the end effector of FIG. 35 with the end effector in a closed or clamped position;

FIG. 37 is an enlarged view of a portion of the end effector and surgical instrument embodiment depicted in FIG. 36;

FIG. 38 is a cross-sectional view of a portion of the handle assembly of the surgical instrument of FIG. 31;

FIG. 39 is another cross-sectional view of the portion of the handle assembly of FIG. 38 taken along line 39-39 in FIG. 38;

FIG. 40 is a partial perspective exploded view of an articulation ball and socket arrangement of various embodiments of the present invention;

FIG. 41 is a top view of an end effector and a portion of an elongated shaft assembly of another surgical instrument embodiment of the present invention in an unarticulated orientation;

FIG. 42 is another top view of the end effector and portion of elongated shaft assembly of FIG. 41 in an articulated position;

FIG. 43 is cross-sectional view of another surgical instrument embodiment of the present invention;

FIG. 44 is partial cross-sectional view of a portion of the articulated shaft assembly of the surgical instrument embodiment of FIG. 43;

FIG. 44A is a cross-sectional view of a portion of the articulated shaft assembly of FIG. 44;

FIG. 44B is another cross-sectional view of another portion of the articulated shaft assembly of FIG. 44;

FIG. 44C is another cross-sectional view of another portion of the articulated shaft assembly of FIG. 44;

FIG. 44D is another cross-sectional view of another portion of the articulated shaft assembly of FIG. 44;

FIG. 44E is another cross-sectional view of another portion of the articulated shaft assembly of FIG. 44;

FIG. 44F is another cross-sectional view of another portion of the articulated shaft assembly of FIG. 44;

FIG. 45 is a partial cross-sectional view of the articulated shaft assembly of FIG. 44 taken along line 45-45 in FIG. 44;

FIG. 46 is a partial cross-sectional view of the articulated shaft assembly of FIG. 44 taken along line 46-46 in FIG. 44;

FIG. 47 is another cross-sectional view of the surgical instrument of FIG. 43 with the end effector thereof shown in a fully articulated position;

FIG. 48 is a cross-sectional view of the end effector of FIG. 47 with a bellows-like cover extending over the articulation joint;

FIG. 49 is a cross-section view of a handle assembly of another surgical instrument embodiment of the present invention;

FIG. 50 is a cross-sectional exploded assembly view of an end effector and the distal end of the elongated shaft assembly of FIG. 49;

FIG. 51 is another cross-sectional view of the end effector and portion of elongated shaft assembly of FIG. 50 with the end effector in an open position;

FIG. 52 is another cross-sectional view of the end effector and portion of the elongated shaft assembly with the end effector in a closed position;

FIG. 53 is another cross-sectional view of the end effector and portion of the elongated shaft of FIGS. 49-52 with the knife member in a fully fired position;

FIG. 54 is a perspective view of the end effector of FIGS. 51-53 in an open position;

FIG. 55 is a cross-sectional view of the end effector of FIGS. 51-54 taken along line 55-55 in FIG. 51;

FIG. 56 is a partial perspective view of an elongated shaft assembly of another embodiment of the present invention attached to an end effector embodiment of the present invention;

FIG. 57 is a partial cross-sectional view of a handle assembly of another surgical instrument embodiment of the present invention;

FIG. 58 is a cross-sectional view of a portion of the elongated shaft assembly of FIGS. 56 and 57 taken along line 58-58 in FIG. 57;

FIG. 59 is an enlarged view of a portion of the handle assembly of FIG. 57;

FIG. 60 is a cross-sectional view of a distal end portion of the elongated shaft assembly of FIGS. 56-59;

FIG. 61 is a partial perspective view of an elongated shaft assembly of another embodiment of the present invention attached to an end effector embodiment of the present invention;

FIG. 62 is a cross-sectional view of a portion of a reconfigurable shaft segment of the elongated shaft of FIG. 61;

FIG. 63 is a partial perspective view of an elongated shaft assembly of another embodiment of the present invention attached to an end effector embodiment of the present invention;

FIG. 64 is a cross-sectional view of a handle assembly of another surgical instrument embodiment of the present invention;

FIG. 65 is a cross-sectional view of a portion of the elongated shaft assembly of FIGS. 63 and 64 taken along line 65-65 in FIG. 64;

FIG. 66 is an enlarged view of a portion of the handle assembly of FIG. 64;

FIG. 67 is a cross-sectional view of a portion of the reconfigurable shaft segment depicted in FIG. 63 with the tubular link portions thereof aligned in a substantially straight line;

FIG. 68 is a cross-sectional view of a portion of the reconfigurable shaft segment depicted in FIGS. 63 and 67 with the tubular link portions thereof aligned in a substantially curved (non-coaxial) orientation;

FIG. 69 is a perspective view of an alternative staple cartridge embodiment of the present invention installed in a surgical cutting and stapling device embodiment of the present invention;

FIG. 70 is a top view of the surgical staple cartridge and elongated channel of the device depicted in FIG. 69;

FIG. 71 is a top view of another surgical staple cartridge embodiment of the present invention installed in an elongated channel of an end effector embodiment of the present invention;

FIG. 72 is a bottom view of an anvil embodiment of the present invention;

FIG. 73 is a partial perspective view of a plurality of staples forming a portion of a staple line embodiment of the present invention;

FIG. 74 is another partial perspective view of the staple line embodiment of FIG. 73 with the staples thereof after being formed by being contacted by the anvil of the surgical cutting and stapling device;

FIG. 75 is a partial perspective view of alternative staples forming a portion of another staple line embodiment of the present invention;

FIG. 76 is a partial perspective view of alternative staples forming a portion of another staple line embodiment of the present invention;

FIG. 77 is a partial perspective view of alternative staples forming a portion of another staple line embodiment of the present invention;

FIG. 78 is a cross-sectional view of an end effectors embodiment of the present invention supporting a staple cartridge embodiment of the present invention;

FIG. 79 is a cross-sectional view of the elongated channel portion of the end effector of FIG. 78 after the implantable staple cartridge body portion and staples have been removed therefrom;

FIG. 80 is a cross-sectional view of an end effectors embodiment of the present invention supporting another staple cartridge embodiment of the present invention;

FIG. 81 is a partial cross-sectional view of a surgical stapling instrument embodiment of the present invention with a staple cartridge supported in the end effector thereof to move the cartridge locking system to an unlocked position;

FIG. 82 is another partial cross-sectional view of the surgical stapling instrument of FIG. 81 with the staple cartridge being removed from the end effector and the cartridge locking system in a locked position;

FIGS. 83A-83D diagram the deformation of a surgical staple positioned within a collapsible staple cartridge body in accordance with at least one embodiment;

FIG. 84A is a diagram illustrating a staple positioned in a crushable staple cartridge body;

FIG. 84B is a diagram illustrating the crushable staple cartridge body of FIG. 84A being crushed by an anvil;

FIG. 84C is a diagram illustrating the crushable staple cartridge body of FIG. 84A being further crushed by the anvil;

FIG. 84D is a diagram illustrating the staple of FIG. 84A in a fully formed configuration and the crushable staple cartridge of FIG. 84A in a fully crushed condition;

FIG. 85 is a diagram depicting a staple positioned against a staple cartridge support surface and illustrating potential relative movement therebetween;

FIG. 86 is a cross-sectional view of a staple cartridge support surface comprising a slot, or trough, configured to stabilize the base of the staple of FIG. 85;

FIG. 87 is a cross-sectional view of a staple comprising an overmolded crown and a slot, or trough, configured to receive a portion of the crown in accordance with at least one alternative embodiment;

FIG. 88 is a top view of a staple cartridge in accordance with at least one embodiment comprising staples embedded in a collapsible staple cartridge body;

FIG. 89 is an elevational view of the staple cartridge of FIG. 88;

FIG. 90 is an elevational view of a staple cartridge in accordance with at least one embodiment comprising a protective layer surrounding staples positioned within a collapsible staple cartridge body;

FIG. 91 is a cross-sectional view of the staple cartridge of FIG. 90 taken along line 91-91 in FIG. 90;

FIG. 92 is an elevational view of a staple cartridge in accordance with at least one embodiment comprising staples at least partially extending outside of a collapsible staple cartridge body and a protective layer surrounding the staple cartridge body;

FIG. 93 is a cross-sectional view of the staple cartridge of FIG. 92 taken along line 93-93 in FIG. 92;

FIG. 94 is a partial break-away view of a staple cartridge in accordance with at least one embodiment comprising staples at least partially embedded in a collapsible staple cartridge body, the staples being at least partially positioned in a staple cavity void in the staple cartridge body;

FIG. 95 is a cross-sectional view of the staple cartridge of FIG. 94 taken along line 95-95 in FIG. 94;

FIG. 96 is a partial break-away view of a staple cartridge in accordance with at least one embodiment;

FIG. 97 is a partial break-away view of a staple cartridge in accordance with at least one embodiment comprising staples at least partially embedded within a collapsible staple cartridge body and an alignment matrix connecting the staples and aligning the staples with respect to each other;

FIG. 98 is a cross-sectional view of the staple cartridge of FIG. 97 taken along line 98-98 in FIG. 97;

FIG. 99 is partial cut-away view of an inner layer of a compressible staple cartridge body;

FIG. 100 is a diagram illustrating the inner layer of FIG. 99 compressed between a transfer plate and a support plate;

FIG. 101 is a diagram illustrating staples being inserted into the compressed inner layer of FIG. 100;

FIG. 102 is a diagram of the support plate of FIG. 100 being removed away from the inner layer;

FIG. 103 is a diagram of a subassembly comprising the inner layer of FIG. 99 and the staples of FIG. 101 being inserted into an outer layer;

FIG. 104 is a diagram illustrating the outer layer of FIG. 103 being sealed to form a sealed staple cartridge;

FIG. 105 is a cross-sectional view of the sealed staple cartridge of FIG. 104;

FIG. 106 is a cross-sectional view of a staple cartridge and staple cartridge channel in accordance with at least one embodiment;

FIG. 107 is a diagram illustrating a portion of the staple cartridge of FIG. 106 in a deformed state;

FIG. 108 is an elevational view of an end effector of a surgical stapler comprising an anvil in an open position and a staple cartridge positioned within a staple cartridge channel;

FIG. 109 is an elevational view of the end effector of FIG. 108 illustrating the anvil in a closed position and the staple cartridge compressed between the anvil and the staple cartridge channel;

FIG. 110 is an elevational view of the end effector of FIG. 108 illustrating the staple cartridge of FIG. 108 positioned within the staple cartridge channel in an alternative manner;

FIG. 111 is a cross-sectional view of an end effector of a surgical stapler comprising a compressible staple cartridge positioned within a staple cartridge channel and a piece of buttress material attached to an anvil;

FIG. 112 is a cross-sectional view of the end effector of FIG. 111 illustrating the anvil in a closed position;

FIG. 113 is a cross-sectional view of an alternative embodiment of an end effector of a surgical stapler comprising a staple cartridge comprising a water impermeable layer;

FIG. 114 is a cross-sectional view of another alternative embodiment of an end effector of a surgical stapler;

FIG. 115 is a cross-sectional view of an alternative embodiment of an end effector of a surgical stapler comprising a stepped anvil and a staple cartridge comprising a stepped cartridge body;

FIG. 116 is a cross-sectional view of another alternative embodiment of an end effector of a surgical stapler;

FIG. 117 is a cross-sectional view of an alternative embodiment of an end effector of a surgical stapler comprising inclined tissue-contacting surfaces;

FIG. 118 is a cross-sectional view of another alternative embodiment of an end effector of a surgical stapler comprising inclined tissue-contacting surfaces;

FIG. 119 is a cross-sectional view of an alternative embodiment of an end effector of a surgical stapler comprising a support insert configured to support a staple cartridge;

FIG. 120 is a cross-sectional view of an alternative embodiment of an end effector of a surgical stapler comprising a staple cartridge comprising a plurality of compressible layers;

FIG. 121 is a cross-sectional view of an alternative embodiment of an end effector of a surgical stapler comprising a staple cartridge comprising a stepped compressible cartridge body;

FIG. 122 is a cross-sectional view of another alternative embodiment of an end effector of a surgical stapler comprising a staple cartridge comprising a stepped compressible cartridge body;

FIG. 123 is a cross-sectional view of an alternative embodiment of an end effector of a surgical stapler comprising a staple cartridge comprising a curved tissue-contacting surface;

FIG. 124 is a cross-sectional view of an alternative embodiment of an end effector of a surgical stapler comprising a staple cartridge having an inclined tissue-contacting surface;

FIG. 125 is a cross-sectional view of a compressible staple cartridge comprising staples and at least one medicament stored therein;

FIG. 126 is a diagram illustrating the compressible staple cartridge of FIG. 125 after it has been compressed and the staples contained therein have been deformed;

FIG. 127 is a partial cut-away view of a staple cartridge in accordance with at least one embodiment;

FIG. 128 is a cross-sectional view of the staple cartridge of FIG. 127;

FIG. 129 is a perspective view of an implanted staple cartridge in accordance with at least one alternative embodiment;

FIG. 130 is a cross-sectional view of the implanted staple cartridge of FIG. 129;

FIG. 131 is a perspective view of an alternative embodiment of a staple cartridge comprising deformable members extending from an outer layer of the staple cartridge;

FIG. 132 is a perspective view of an alternative embodiment of a staple cartridge comprising an outer layer of the staple cartridge being assembled to an inner layer;

FIG. 133 is a cross-sectional view of an alternative embodiment of a staple cartridge comprising a plurality of staples, a compressible layer, and a pledget layer;

FIG. 134 is a perspective view of the pledget layer of FIG. 133;

FIG. 135 is a perspective view of a pledget singulated from the pledget layer of FIG. 133 and a staple aligned with a groove in the pledget;

FIG. 136 is a perspective view of two connected pledgets from the pledget layer of FIG. 133;

FIG. 137 is a perspective view of a pledget support frame of the pledget layer of FIG. 133 being removed from the singulated pledgets;

FIG. 138 is an exploded perspective view of an alternative embodiment of a compressible staple cartridge comprising staples therein and a system for driving the staples against an anvil;

FIG. 138A is a partial cut-away view of an alternative embodiment of the staple cartridge of FIG. 138;

FIG. 139 is a cross-sectional view of the staple cartridge of FIG. 138;

FIG. 140 is an elevational view of a sled configured to traverse the staple cartridge of FIG. 138 and move the staples to toward the anvil;

FIG. 141 is a diagram of a staple driver which can be lifted toward the anvil by the sled of FIG. 140;

FIG. 142 is a break-away view of a staple cartridge in accordance with at least one alternative embodiment comprising staples positioned within staple drivers;

FIG. 143 is a cross-sectional view of the staple cartridge of FIG. 142 positioned within a staple cartridge channel;

FIG. 144 is a cross-sectional view of the staple cartridge of FIG. 142 illustrating an anvil moved into a closed position and staples contained within the staple cartridge deformed by the anvil;

FIG. 145 is a cross-sectional view of the staple cartridge of FIG. 142 illustrating the staples moved upwardly toward the anvil;

FIG. 146 is a perspective view of an alternative embodiment of a staple cartridge comprising straps connecting the flexible sides of the staple cartridge;

FIG. 147 is a perspective view of a sled and cutting member assembly;

FIG. 148 is a diagram of the sled and cutting member assembly of FIG. 147 being used to lift the staples of the staple cartridge of FIG. 142;

FIG. 149 is a diagram illustrating a sled configured to engage and lift staples toward an anvil and a lock-out system configured to selectively permit the sled to move distally;

FIGS. 150A-150C illustrate the progression of a staple being inserted into a staple crown;

FIG. 151 is a cross-sectional view of a staple cartridge comprising a support pan or retainer;

FIG. 152 is a partial cross-sectional view of a compressible staple cartridge in accordance with at least one alternative embodiment;

FIG. 153 is a diagram illustrating the staple cartridge of FIG. 152 in an implanted condition;

FIG. 154 is a partial cut-away view of a compressible staple cartridge in accordance with at least one alternative embodiment;

FIG. 155 is a partial cross-sectional view of the staple cartridge of FIG. 154;

FIG. 156 is a diagram illustrating the staple cartridge of FIG. 154 in an implanted condition;

FIG. 157 is a partial cross-sectional view of a crushable staple cartridge in accordance with at least one alternative embodiment;

FIG. 158 is a partial cut-away view of a collapsible staple cartridge in accordance with at least one embodiment comprising a plurality of collapsible elements;

FIG. 159 is a perspective view of a collapsible element of FIG. 158 in an uncollapsed state;

FIG. 160 is a perspective view of the collapsible element of FIG. 159 in a collapsed state;

FIG. 161A is a partial cross-sectional view of an end effector of a surgical stapling instrument comprising a jaw, a staple cartridge channel positioned opposite the jaw, and a staple cartridge positioned within the staple cartridge channel, wherein the jaw comprises a retention matrix attached thereto;

FIG. 161B is a partial cross-sectional view of the end effector of FIG. 161A illustrating the jaw being moved toward the staple cartridge channel, the staple cartridge being compressed by the anvil and the retention matrix, and a staple at least partially extending through tissue positioned intermediate the retention matrix and the staple cartridge;

FIG. 161C is a partial cross-sectional view of the end effector of FIG. 161A illustrating the jaw in a final position and the retention matrix engaged with the staple of FIG. 161B;

FIG. 161D is a partial cross-sectional view of the end effector of FIG. 161A illustrating the jaw and the staple cartridge channel being moved away from the implanted staple cartridge and retention matrix;

FIG. 162 is a perspective view of a retention aperture of a retention matrix in accordance with at least one alternative embodiment comprising a plurality of retention members configured to engage a fastener leg extending therethrough;

FIG. 163 is a perspective view of a retention aperture of a retention matrix in accordance with at least one alternative embodiment comprising six retention members;

FIG. 164 is a perspective view of a retention aperture of a retention matrix in accordance with at least one alternative embodiment comprising eight retention members;

FIG. 165 is a perspective view of a retention aperture of a retention matrix in accordance with at least one alternative embodiment comprising a plurality of retention members configured to engage a fastener leg extending therethrough;

FIG. 166 is a perspective view of a retention aperture of a retention matrix in accordance with at least one alternative embodiment comprising six retention members;

FIG. 167 is a perspective view of a retention aperture of a retention matrix in accordance with at least one alternative embodiment comprising eight retention members;

FIG. 168 is a perspective view of a retention aperture of a retention matrix in accordance with at least one alternative embodiment comprising a plurality of retention members that have been stamped from a sheet of metal;

FIG. 169 is a perspective view of a retention aperture of a retention matrix in accordance with at least one alternative embodiment comprising a plurality of apertures extending around the perimeter of the retention aperture;

FIG. 170 is a top view of a retention aperture of a retention matrix in accordance with at least one alternative embodiment;

FIG. 171 is a top view of a retention aperture of a retention matrix in accordance with at least one alternative embodiment;

FIG. 172 is a top view of a retention aperture of a retention matrix in accordance with at least one alternative embodiment;

FIG. 173 is a top view of a retention aperture of a retention matrix in accordance with at least one alternative embodiment;

FIG. 174 is a top view of a retention aperture of a retention matrix in accordance with at least one alternative embodiment;

FIG. 175 is a top view of a retention aperture of a retention matrix comprising a retention tab extending into the retention aperture in accordance with at least one embodiment;

FIG. 176 is a top view of a retention aperture of a retention matrix comprising a retention tab extending into the retention aperture in accordance with at least one alternative embodiment;

FIG. 177 is a perspective view of a fastening system comprising a plurality of staples, a retention matrix engaged with the staples, and an alignment matrix configured to align the staples;

FIG. 178 is a perspective view of the retention matrix of FIG. 177;

FIG. 179 is a perspective view of the alignment matrix of FIG. 177;

FIG. 180 is a partial top view of the retention matrix of FIG. 177 engaged with the staples of FIG. 177;

FIG. 181 is a partial bottom view of the retention matrix of FIG. 177 engaged with the staples of FIG. 177;

FIG. 182 is a partial elevational view of the fastening system of FIG. 177;

FIG. 183 is a partial perspective view of the fastening system of FIG. 177;

FIG. 184 is a partial cross-sectional view of the retention matrix of FIG. 177 engaged with the staples of FIG. 177;

FIG. 185 is a partial cross-sectional view of the fastening system of FIG. 177;

FIG. 186 is a perspective view of the fastening system of FIG. 177 further comprising protective caps assembled to the legs of the staples;

FIG. 187 is a bottom perspective view of the fastening system arrangement of FIG. 186;

FIG. 188 is a partial perspective view of the fastening system arrangement of FIG. 186;

FIG. 189 is a partial cross-sectional view of the fastening system arrangement of FIG. 186;

FIG. 190 is an elevational view of an end effector in accordance with at least one embodiment comprising a jaw in an open position, a retention matrix and a plurality of protective caps positioned in the jaw, and a staple cartridge positioned in a staple cartridge channel;

FIG. 191 is an elevational view of the end effector of FIG. 190 in a closed position;

FIG. 192 is an elevational view of the end effector of FIG. 190 in a fired position;

FIG. 193 is an elevational view of the retention matrix and protective caps of FIG. 190 assembled to the staple cartridge of FIG. 190;

FIG. 194 is a detail view of the arrangement of FIG. 193;

FIG. 195 is an elevational view of the end effector of FIG. 190 illustrating the jaw in an open position with thinner tissue positioned between the retention matrix and the staple cartridge;

FIG. 196 is an elevational view of the end effector of FIG. 190 illustrating the jaw in a closed position against the thinner tissue of FIG. 195;

FIG. 197 is an elevational view of the end effector of FIG. 190 illustrating the jaw in a fired position to capture the thinner tissue of FIG. 195 between the retention matrix and the staple cartridge;

FIG. 198 is an elevational view of the retention matrix and the protective caps of FIG. 190 assembled to the staple cartridge of FIG. 190 with the thin tissue of FIG. 195 positioned therebetween;

FIG. 199 is a detail view of the arrangement of FIG. 198;

FIG. 200 is a cross-sectional view of a protective cap positioned on the tip of a staple leg in accordance with at least one alternative embodiment;

FIG. 201 is a perspective view of a plurality of protective caps embedded within a sheet of material;

FIG. 202 is a perspective view of a jaw comprising a plurality of recesses configured to receive a plurality of protective caps therein;

FIG. 203 is a detail view of a portion of a jaw comprising a sheet covering the protective caps positioned within the jaw of FIG. 202;

FIG. 204 is a cross-sectional view of a protective cap positioned on a tip of a staple leg in accordance with at least one alternative embodiment wherein the protective cap comprises an interior forming surface;

FIG. 205 is another cross-sectional view of the protective cap of FIG. 204 illustrating the staple leg being deformed against the forming surface;

FIG. 206 is a top view of an alternative embodiment of a retention matrix comprising a plurality of connected matrix elements;

FIG. 207 is a top view of an alternative embodiment of a retention matrix comprising a plurality of connected matrix elements;

FIG. 208 is a top view of an alternative embodiment of a retention matrix comprising a plurality of connected matrix elements;

FIG. 209 is a top view of an alternative embodiment of an array of retention matrices comprising a plurality of connected matrix elements;

FIG. 210 is a top view of an alternative embodiment of a retention matrix comprising a plurality of connected matrix elements;

FIG. 211 is a partial exploded view of a jaw comprising a retention matrix including a compressible cover;

FIG. 212 is a detail view of the retention matrix of FIG. 211;

FIG. 213 is a partial cross-sectional view of a fastening system comprising a retention matrix including a compressible layer and a plurality of cells encapsulating one or more medicaments;

FIG. 214 is a diagram illustrating staple legs which have pierced the cells of FIG. 213 as they are being engaged with the retention matrix;

FIG. 215 is a partial cross-sectional view of a fastening system comprising a retention matrix including a compressible layer;

FIG. 216 is an elevational view of a fastener cartridge insertion assembly comprising a holder, a first fastener cartridge, and a second fastener cartridge;

FIG. 217 is an elevational view of an end effector of a surgical stapler comprising a first jaw and a second jaw, the second jaw being illustrated in an open configuration;

FIG. 218 is an elevational view of the end effector of FIG. 217 illustrating the second jaw in a closed configuration and the fastener cartridge insertion assembly of FIG. 216 being used to load the first jaw with the first cartridge and the second jaw with the second cartridge;

FIG. 219 is an elevational view of the loaded end effector of FIG. 218 illustrating the cartridge insertion assembly removed from the end effector, the second jaw in an open configuration once again, and tissue positioned intermediate the first jaw and the second jaw;

FIG. 220 is an elevational view of the loaded end effector of FIG. 219 in a fired configuration;

FIG. 221 is an elevational view of the first cartridge and the second cartridge in an implanted condition;

FIG. 222 is an elevational view of the end effector of FIG. 217 illustrating a portion of the first cartridge still engaged with the first jaw in accordance with at least one embodiment;

FIG. 223 is an elevational view of an alternative embodiment of a fastener cartridge insertion assembly comprising a holder, a first fastener cartridge, and a second fastener cartridge;

FIG. 224 is an elevational view of the fastener cartridge insertion assembly of FIG. 223 being used to load a first jaw of an end effector with the first cartridge and a second jaw with the second cartridge;

FIG. 225 is a cross-sectional view of the loaded end effector of FIG. 224;

FIG. 226 is a perspective view of a surgical stapler comprising a bottom jaw and a top jaw in accordance with at least one embodiment illustrated with portions of the surgical stapler removed;

FIG. 227 is a perspective view of the surgical stapler of FIG. 226 with the top jaw removed;

FIG. 228 is a perspective view of a slidable anvil system of the top jaw of the surgical stapler of FIG. 226 comprising a first slidable anvil and a second slidable anvil;

FIG. 229 is an end view of the slidable anvil system of FIG. 228;

FIG. 230 is a top view of the slidable anvil system of FIG. 228;

FIG. 231 is a diagram illustrating the slidable anvil system of FIG. 228 in an unfired condition;

FIG. 232 is a diagram illustrating the first slidable anvil of the slidable anvil system of FIG. 228 in an unfired position and staples positioned within the bottom jaw in an undeployed position;

FIG. 233 is a diagram illustrating the staples in the bottom jaw in a deployed configuration and the first slidable anvil of FIG. 232 being pulled proximally to deform a first group of staple legs of the staples;

FIG. 234 is a diagram illustrating the first group of staples of FIG. 233 deformed to a fully deformed state;

FIG. 235 is a diagram illustrating the second slidable anvil of the slidable anvil system of FIG. 228 being pushed distally to deform a second group of staple legs;

FIG. 236 is a partial perspective view of an anvil comprising a plurality of forming pockets in at least one embodiment;

FIG. 237 is a cross-sectional end view of the anvil of FIG. 236;

FIG. 238 is a diagram illustrating a first step in manufacturing the forming pockets of FIG. 236;

FIG. 239 is a diagram illustrating a second step in manufacturing the forming pockets of FIG. 236;

FIG. 240 is a top view of the forming pocket arrangement of the anvil of FIG. 236;

FIG. 241 is a diagram illustrating a first step of a manufacturing process for producing an anvil;

FIG. 242 is a diagram illustrating a second step in the manufacturing process of FIG. 241;

FIG. 243 is a diagram illustrating a third step in the manufacturing process of FIG. 241;

FIG. 244 is an exploded view of a shaft and an end effector of a surgical stapling instrument illustrated with a staple cartridge positioned within the end effector in accordance with at least one embodiment;

FIG. 245 is an exploded view of the end effector and staple cartridge of FIG. 244;

FIG. 246 is a perspective view of a support jaw of the end effector and the staple cartridge of FIG. 244 illustrated with some components removed;

FIG. 247 is a cross-sectional elevational view of the end effector of FIG. 244 illustrated in an open configuration with a vessel positioned between the staple cartridge and an anvil jaw of the end effector;

FIG. 248 is a cross-sectional elevational view of the end effector of FIG. 244 illustrated in a partially closed configuration;

FIG. 249 is a cross-sectional elevational view of the end effector of FIG. 244 illustrated in a closed and at least partially fired configuration;

FIG. 250 is a cross-sectional elevational view of the end effector of FIG. 244 illustrated in a fully fired configuration;

FIG. 251 is a cross-sectional perspective view of the end effector of FIG. 244 illustrated in an at least partially closed, unfired configuration;

FIG. 252 is a cross-sectional perspective view of the end effector of FIG. 244 illustrated in closed, partially fired configuration;

FIG. 253 is a cross-sectional end view of the end effector of FIG. 244 illustrated in an open configuration;

FIG. 254 is a cross-sectional end view of the end effector of FIG. 244 illustrated in an at least partially closed configuration;

FIG. 255 is a cross-sectional end view of the end effector of FIG. 244 illustrated in a fired configuration;

FIG. 256 is a cross-sectional end view of the end effector of FIG. 244 illustrated in an unfired configuration with some components removed;

FIG. 257 is a cross-sectional end view of the end effector of FIG. 244 illustrated in a fired configuration with some components removed;

FIG. 258 is a top perspective view of the end effector of FIG. 244;

FIG. 259 is an exploded view of an end effector of a surgical stapling instrument and a staple cartridge in accordance with at least one embodiment;

FIG. 260 is an exploded view of the end effector and a shaft of the surgical stapling instrument of FIG. 259;

FIG. 261 is an exploded elevational view of the end effector of FIG. 259; and

FIG. 262 is cross-sectional elevational view of the end effector of FIG. 259 illustrated in a partially fired configuration.

Corresponding reference characters indicate corresponding parts throughout the several views. The exemplifications set out herein illustrate preferred embodiments of the invention, in one form, and such exemplifications are not to be construed as limiting the scope of the invention in any manner.

DETAILED DESCRIPTION

The Applicant of the present application also owns the U.S. Patent Applications identified below which are each herein incorporated by reference in their respective entirety:

U.S. patent application Ser. No. 12/894,360, entitled SURGICAL STAPLING INSTRUMENT WITH A VARIABLE STAPLE FORMING SYSTEM, now U.S. Patent Application Publication No. 2012/0080484;

U.S. patent application Ser. No. 12/894,322, entitled SURGICAL STAPLING INSTRUMENT WITH INTERCHANGEABLE STAPLE CARTRIDGE ARRANGEMENTS, now U.S. Pat. No. 8,740,034;

U.S. patent application Ser. No. 12/894,351, entitled SURGICAL CUTTING AND FASTENING INSTRUMENTS WITH SEPARATE AND DISTINCT FASTENER DEPLOYMENT AND TISSUE CUTTING SYSTEMS, now U.S. Patent Application Publication No. 2012/0080502;

U.S. patent application Ser. No. 12/894,339, entitled SURGICAL STAPLING INSTRUMENT WITH COMPACT ARTICULATION CONTROL ARRANGEMENT, now U.S. Pat. No. 8,840,003;

U.S. patent application Ser. No. 12/894,327, entitled JAW CLOSURE ARRANGEMENTS FOR SURGICAL INSTRUMENTS, now U.S. Patent Application Publication No. 2012/0080499;

U.S. patent application Ser. No. 12/894,311, entitled SURGICAL INSTRUMENTS WITH RECONFIGURABLE SHAFT SEGMENTS, now U.S. Pat. No. 8,763,877;

U.S. patent application Ser. No. 12/894,340, entitled SURGICAL STAPLE CARTRIDGES SUPPORTING NON-LINEARLY ARRANGED STAPLES AND SURGICAL STAPLING INSTRUMENTS WITH COMMON STAPLE-FORMING POCKETS, now U.S. Patent Application Publication No. 2012/0080482;

U.S. patent application Ser. No. 12/894,350, entitled SURGICAL STAPLE CARTRIDGES WITH DETACHABLE SUPPORT STRUCTURES AND SURGICAL STAPLING INSTRUMENTS WITH SYSTEMS FOR PREVENTING ACTUATION MOTIONS WHEN A CARTRIDGE IS NOT PRESENT, now U.S. Patent Application Publication No. 2012/0080478;

U.S. patent application Ser. No. 12/894,338, entitled IMPLANTABLE FASTENER CARTRIDGE HAVING A NON-UNIFORM ARRANGEMENT, now U.S. Pat. No. 8,864,007;

U.S. patent application Ser. No. 12/894,312, entitled IMPLANTABLE FASTENER CARTRIDGE COMPRISING MULTIPLE LAYERS, now U.S. Patent Application Publication No. 2012/0080479;

U.S. patent application Ser. No. 12/894,377, entitled SELECTIVELY ORIENTABLE IMPLANTABLE FASTENER CARTRIDGE, now U.S. Pat. No. 8,393,514;

U.S. patent application Ser. No. 12/894,383, entitled IMPLANTABLE FASTENER CARTRIDGE COMPRISING BIOABSORBABLE LAYERS, now U.S. Pat. No. 8,752,699;

U.S. patent application Ser. No. 12/894,389, entitled COMPRESSIBLE FASTENER CARTRIDGE, now U.S. Pat. No. 8,740,037;

U.S. patent application Ser. No. 12/894,345, entitled FASTENERS SUPPORTED BY A FASTENER CARTRIDGE SUPPORT, now U.S. Pat. No. 8,783,542;

U.S. patent application Ser. No. 12/894,306, entitled COLLAPSIBLE FASTENER CARTRIDGE, now U.S. Patent Application Publication No. 2012/0080332;

U.S. patent application Ser. No. 12/894,318, entitled FASTENER SYSTEM COMPRISING A PLURALITY OF CONNECTED RETENTION MATRIX ELEMENTS, now U.S. Pat. No. 8,814,024;

U.S. patent application Ser. No. 12/894,330, entitled FASTENER SYSTEM COMPRISING A RETENTION MATRIX AND AN ALIGNMENT MATRIX, now U.S. Pat. No. 8,757,465;

U.S. patent application Ser. No. 12/894,361, entitled FASTENER SYSTEM COMPRISING A RETENTION MATRIX, now U.S. Pat. No. 8,529,600;

U.S. patent application Ser. No. 12/894,367, entitled FASTENING INSTRUMENT FOR DEPLOYING A FASTENER SYSTEM COMPRISING A RETENTION MATRIX, now U.S. Patent Application Publication No. 2012/0080485;

U.S. patent application Ser. No. 12/894,388, entitled FASTENER SYSTEM COMPRISING A RETENTION MATRIX AND A COVER, now U.S. Pat. No. 8,474,677;

U.S. patent application Ser. No. 12/894,376, entitled FASTENER SYSTEM COMPRISING A PLURALITY OF FASTENER CARTRIDGES, now U.S. Patent Application Publication No. 2012/0080486;

U.S. patent application Ser. No. 12/894,369, entitled IMPLANTABLE FASTENER CARTRIDGE COMPRISING A SUPPORT RETAINER, now U.S. Patent Application Publication No. 2012/0080344;

U.S. patent application Ser. No. 13/097,907, entitled COMPRESSIBLE STAPLE CARTRIDGE ASSEMBLY, now U.S. Patent Application Publication No. 2012/0080338;

U.S. patent application Ser. No. 13/097,861, entitled TISSUE THICKNESS COMPENSATOR COMPRISING PORTIONS HAVING DIFFERENT PROPERTIES, now U.S. Patent Application Publication No. 2012/0080337;

U.S. patent application Ser. No. 13/097,948, entitled STAPLE CARTRIDGE COMPRISING AN ADJUSTABLE DISTAL PORTION, now U.S. Patent Application Publication No. 2012/0083836;

U.S. patent application Ser. No. 13/097,936, entitled TISSUE THICKNESS COMPENSATOR FOR A SURGICAL STAPLER, now U.S. Pat. No. 8,657,176;

U.S. patent application Ser. No. 13/097,865, entitled SURGICAL STAPLER ANVIL COMPRISING A PLURALITY OF FORMING POCKETS, now U.S. Patent Application Publication No. 2012/0080488;

U.S. patent application Ser. No. 13/097,869, entitled STAPLE CARTRIDGE LOADING ASSEMBLY, now U.S. Pat. No. 8,857,694;

U.S. patent application Ser. No. 13/097,954, entitled STAPLE CARTRIDGE COMPRISING A VARIABLE THICKNESS COMPRESSIBLE PORTION, now U.S. Patent Application Publication No. 2012/0080340;

U.S. patent application Ser. No. 13/097,928, entitled TISSUE THICKNESS COMPENSATOR COMPRISING DETACHABLE PORTIONS, now U.S. Pat. No. 8,746,535;

U.S. patent application Ser. No. 13/097,891, entitled TISSUE THICKNESS COMPENSATOR FOR A SURGICAL STAPLER COMPRISING AN ADJUSTABLE ANVIL, now U.S. Pat. No. 8,864,009;

U.S. patent application Ser. No. 13/097,917, entitled COMPRESSIBLE STAPLE CARTRIDGE COMPRISING ALIGNMENT MEMBERS, now U.S. Pat. No. 8,777,004;

U.S. patent application Ser. No. 13/097,873, entitled STAPLE CARTRIDGE COMPRISING A RELEASABLE PORTION, now U.S. Pat. No. 8,740,038;

U.S. patent application Ser. No. 13/097,938, entitled STAPLE CARTRIDGE COMPRISING COMPRESSIBLE DISTORTION RESISTANT COMPONENTS, now U.S. Patent Application Publication No. 2012/0080491;

U.S. patent application Ser. No. 13/097,924, entitled STAPLE CARTRIDGE COMPRISING A TISSUE THICKNESS COMPENSATOR, now U.S. Patent Application Publication No. 2012/0083835; and

U.S. patent application Ser. No. 13/097,856, entitled STAPLE CARTRIDGE COMPRISING STAPLES POSITIONED WITHIN A COMPRESSIBLE PORTION THEREOF, now U.S. Patent Application Publication No. 2012/0080336.

The Applicant of the present application also owns the U.S. patent applications identified below which were filed on even date herewith and which are each herein incorporated by reference in their respective entirety:

U.S. patent application Ser. No. 13/242,066, entitled CURVED END EFFECTOR FOR A STAPLING INSTRUMENT, now U.S. Patent Application Publication No. 2012/0080498;

U.S. patent application Ser. No. 13/241,922, entitled SURGICAL STAPLER WITH STATIONARY STAPLE DRIVERS, now U.S. Patent Application No. 2013/0075449;

U.S. patent application Ser. No. 13/241,912, entitled STAPLE CARTRIDGE INCLUDING COLLAPSIBLE DECK ARRANGEMENT, now U.S. Patent Application Publication No. 2013/0075448;

U.S. patent application Ser. No. 13/242,086, entitled STAPLE CARTRIDGE INCLUDING COLLAPSIBLE DECK, now U.S. Patent Application Publication No. 2013/0075450;

U.S. patent application Ser. No. 13/241,629, entitled SURGICAL INSTRUMENT WITH SELECTIVELY ARTICULATABLE END EFFECTOR, now U.S. Patent Application Publication No. 2012/0074200; and

U.S. patent application Ser. No. 13/241,637, entitled SURGICAL INSTRUMENT WITH TRIGGER ASSEMBLY FOR GENERATING MULTIPLE ACTUATION MOTIONS, now U.S. Pat. No. 8,789,741.

Certain exemplary embodiments will now be described to provide an overall understanding of the principles of the structure, function, manufacture, and use of the devices and methods disclosed herein. One or more examples of these embodiments are illustrated in the accompanying drawings. Those of ordinary skill in the art will understand that the devices and methods specifically described herein and illustrated in the accompanying drawings are non-limiting exemplary embodiments and that the scope of the various embodiments of the present invention is defined solely by the claims. The features illustrated or described in connection with one exemplary embodiment may be combined with the features of other embodiments. Such modifications and variations are intended to be included within the scope of the present invention.

Reference throughout the specification to “various embodiments,” “some embodiments,” “one embodiment,” or “an embodiment”, or the like, means that a particular feature, structure, or characteristic described in connection with the embodiment is included in at least one embodiment. Thus, appearances of the phrases “in various embodiments,” “in some embodiments,” “in one embodiment”, or “in an embodiment”, or the like, in places throughout the specification are not necessarily all referring to the same embodiment. Furthermore, the particular features, structures, or characteristics may be combined in any suitable manner in one or more embodiments. Thus, the particular features, structures, or characteristics illustrated or described in connection with one embodiment may be combined, in whole or in part, with the features structures, or characteristics of one or more other embodiments without limitation. Such modifications and variations are intended to be included within the scope of the present invention.

The terms “proximal” and “distal” are used herein with reference to a clinician manipulating the handle portion of the surgical instrument. The term “proximal” referring to the portion closest to the clinician and the term “distal” referring to the portion located away from the clinician. It will be further appreciated that, for convenience and clarity, spatial terms such as “vertical”, “horizontal”, “up”, and “down” may be used herein with respect to the drawings. However, surgical instruments are used in many orientations and positions, and these terms are not intended to be limiting and/or absolute.

Various exemplary devices and methods are provided for performing laparoscopic and minimally invasive surgical procedures. However, the person of ordinary skill in the art will readily appreciate that the various methods and devices disclosed herein can be used in numerous surgical procedures and applications including, for example, in connection with open surgical procedures. As the present Detailed Description proceeds, those of ordinary skill in the art will further appreciate that the various instruments disclosed herein can be inserted into a body in any way, such as through a natural orifice, through an incision or puncture hole formed in tissue, etc. The working portions or end effector portions of the instruments can be inserted directly into a patient's body or can be inserted through an access device that has a working channel through which the end effector and elongated shaft of a surgical instrument can be advanced.

Turning to the Drawings wherein like numerals denote like components throughout the several views, FIG. 1 depicts a surgical instrument 10 that is capable of practicing several unique benefits of the present invention. The surgical stapling instrument 10 is designed to manipulate and/or actuate various forms and sizes of end effectors 12 that are operably attached thereto. In the embodiment depicted in FIGS. 1 and 2, for example, the end effector 12 includes an elongated channel 14 that forms a lower jaw 13 of the end effector 12. The elongated channel 14 is configured to support an “implantable” staple cartridge 30 and also movably support an anvil 20 that functions as an upper jaw 15 of the end effector 12.

In various embodiments, the elongated channel 14 may be fabricated from, for example, 300 & 400 Series, 17-4 & 17-7 stainless steel, titanium, etc. and be formed with spaced side walls 16. The anvil 20 may be fabricated from, for example, 300 & 400 Series, 17-4 & 17-7 stainless steel, titanium, etc. and have a staple forming undersurface, generally labeled as 22 that has a plurality of staple forming pockets 23 formed therein. See FIGS. 1B-1E. In addition, the anvil 20 has a bifurcated ramp assembly 24 that protrudes proximally therefrom. An anvil pin 26 protrudes from each lateral side of the ramp assembly 24 to be received within a corresponding slot or opening 18 in the side walls 16 of the elongated channel 14 to facilitate its movable or pivotable attachment thereto.

Various forms of implantable staple cartridges may be employed with the various embodiments of the surgical instruments disclosed herein. Specific staple cartridge configurations and constructions will be discussed in further detail below. However, in the embodiment depicted in FIGS. 1A and 9-14, an implantable staple cartridge 30 is shown. In at least one embodiment, the staple cartridge 30 has a body portion 31 that consists of a compressible hemostat material such as, for example, oxidized regenerated cellulose (“ORC”) or a bio-absorbable foam in which lines of unformed metal staples 32 are supported. In at least some embodiments, in order to prevent the staple from being affected and the hemostat material from being activated during the introduction and positioning process, the entire cartridge may be coated or wrapped in a biodegradable film 38 such as a polydioxanon film sold under the trademark PDS® or with a Polyglycerol sebacate (PGS) film or other biodegradable films formed from PGA (Polyglycolic acid, marketed under the trade mark Vicryl), PCL (Polycaprolactone), PLA or PLLA (Polylactic acid), PHA (polyhydroxyalkanoate), PGCL (poliglecaprone 25, sold under the trademark Monocryl) or a composite of PGA, PCL, PLA, PDS that would be impermeable until ruptured. The body 31 of staple cartridge 30 is sized to be removably supported within the elongated channel 14 as shown such that each staple 32 therein is aligned with corresponding staple forming pockets 23 in the anvil when the anvil 20 is driven into forming contact with the staple cartridge 30.

In use, once the end effector 12 has been positioned adjacent the target tissue, the end effector 12 is manipulated to capture or clamp the target tissue between an upper face 36 of the staple cartridge 30 and the staple forming surface 22 of the anvil 20. The staples 32 are formed by moving the anvil 20 in a path that is substantially parallel to the elongated channel 14 to bring the staple forming surface 22 and, more particularly, the staple forming pockets 23 therein into substantially simultaneous contact with the upper face 36 of the staple cartridge 30. As the anvil 20 continues to move into the staple cartridge 30, the legs 34 of the staples 32 contact a corresponding staple forming pocket 23 in anvil 20 which serves to bend the staple legs 34 over to form the staples 32 into a “B shape”. Further movement of the anvil 20 toward the elongated channel 14 will further compress and form the staples 32 to a desired final formed height “FH”.

The above-described staple forming process is generally depicted in FIGS. 1B-1E. For example, FIG. 1B illustrates the end effector 12 with target tissue “T” between the anvil 20 and the upper face 36 of the implantable staple cartridge 30. FIG. 1C illustrates the initial clamping position of the anvil 20 wherein the anvil has 20 been closed onto the target tissue “T” to clamp the target tissue “T” between the anvil 20 and the upper face 36 of the staple cartridge 30. FIG. 1D illustrates the initial staple formation wherein the anvil 20 has started to compress the staple cartridge 30 such that the legs 34 of the staples 32 are starting to be formed by the staple forming pockets 23 in the anvil 20. FIG. 1E illustrates the staple 32 in its final formed condition through the target tissue “T” with the anvil 20 removed for clarity purposes. Once the staples 32 have been formed and fastened to the target tissue “T”, the surgeon will move the anvil 20 to the open position to enable the cartridge body 31 and the staples 32 to remain affixed to the target tissue while the end effector 12 is being withdrawn from the patient. The end effector 12 forms all of the staples simultaneously as the two jaws 13, 15 are clamped together. The remaining “crushed” body materials 31 act as both a hemostat (the ORC) and a staple line reinforcement (PGA, PDS or any of the other film compositions mentioned above 38). Also, since the staples 32 never have to leave the cartridge body 31 during forming, the likelihood of the staples 32 being malformed during forming is minimized. As used herein the term “implantable” means that, in addition to the staples, the cartridge body materials that support the staples will also remain in the patient and eventually be absorbed by the patient's body. Such implantable staple cartridges are distinguishable from prior cartridge arrangements that remain with the end effector and are removed therewith. Those “removable” staple cartridges typically include staple driver components and therefore may be much larger than the end effectors of the present invention that are designed to be employed in connection with certain unique and novel implantable staple cartridge embodiments of the present invention.

In various implementations, the end effector 12 is configured to be coupled to an elongated shaft assembly 40 that protrudes from a handle assembly 100. The end effector 12 (when closed) and the elongated shaft assembly 40 may have similar cross-sectional shapes and be sized to operably pass through a trocar tube or working channel in another form of access instrument. As used herein, the term “operably pass” means that the end effector and at least a portion of the elongated shaft assembly may be inserted through or passed through the channel or tube opening and can be manipulated therein as needed to complete the surgical stapling procedure. In some embodiments, when in a closed position, the jaws 13 and 15 of the end effector 12 may provide the end effector with a roughly circular cross-sectional shape that facilitates its passage through a circular passage/opening. However, the end effectors of various embodiments of the present invention, as well as the elongated shaft assembly embodiments, could conceivably be provided with other cross-sectional shapes that could otherwise pass through access passages and openings that have non-circular cross-sectional shapes. Thus, an overall size of a cross-section of a closed end effector will be related to the size of the passage or opening through which it is intended to pass. Thus, one end effector for example, may be referred to as a “5 mm” end effector which means it can operably pass through an opening that is at least approximately 5 mm in diameter.

In various embodiments of the present invention, the elongated shaft assembly 40 may have an outer diameter that is substantially the same as the outer diameter of the end effector 12 when in a closed position. For example, a 5 mm end effector may be coupled to an elongated shaft assembly 40 that has 5 mm cross-sectional diameter. However, as the present Detailed Description proceeds, it will become apparent that various embodiments of the present may be effectively used in connection with different sizes of end effectors. For example, a 10 mm end effector may be attached to an elongated shaft that has a 5 mm cross-sectional diameter. Conversely, for those applications wherein a 10 mm or larger access opening or passage is provided, the elongated shaft assembly 40 may have a 10 mm (or larger) cross-sectional diameter, but may also be able to actuate a 5 mm or 10 mm end effector. Accordingly, the outer shaft 40 may have an outer diameter that is the same as or is different from the outer diameter of a closed end effector 12 attached thereto.

As depicted, the elongated shaft assembly 40 extends distally from the handle assembly 100 in a generally straight line to define a longitudinal axis A-A. In various embodiments, for example, the elongated shaft assembly 40 may be approximately 9-16 inches (229-406 mm) long. However, the elongated shaft assembly 40 may be provided in other lengths and, in other embodiments, may have joints therein or be otherwise configured to facilitate articulation of the end effector 12 relative to other portions of the shaft or handle assembly as will be discussed in further detail below. In various embodiments, the elongated shaft assembly 40 includes a spine member 50 that extends from the handle assembly 100 to the end effector 12. The proximal end of the elongated channel 14 of the end effector 12 has a pair of retention trunions 17 protruding therefrom that are sized to be received within corresponding trunion openings or cradles 52 that are provided in a distal end of the spine member 50 to enable the end effector 12 to be removably coupled the elongated shaft assembly 40. The spine member 50 may be fabricated from, for example, 6061 or 7075 aluminum, stainless steel, titanium, etc.

In various embodiments, the handle assembly 100 comprises a pistol grip-type housing that may be fabricated in two or more pieces for assembly purposes. For example, the handle assembly 100 as shown comprises a right hand case member 102 and a left hand case member 104 (FIGS. 5, 7, and 8) that are molded or otherwise fabricated from a polymer or plastic material and are designed to mate together. Such case members 102 and 104 may be attached together by snap features, pegs and sockets molded or otherwise formed therein and/or by adhesive, screws, etc. The spine member 50 has a proximal end 54 that has a flange 56 formed thereon. The flange 56 is configured to be rotatably supported within a groove 106 formed by mating ribs 108 that protrude inwardly from each of the case members 102, 104. Such arrangement facilitates the attachment of the spine member 50 to the handle assembly 100 while enabling the spine member 50 to be rotated relative to the handle assembly 100 about the longitudinal axis A-A in a 360° path.

As can be further seen in FIGS. 1 and 4, the spine member 50 passes through and is supported by a mounting bushing 60 that is rotatably affixed to the handle assembly 100. The mounting bushing 60 has a proximal flange 62 and a distal flange 64 that define a rotational groove 65 that is configured to rotatably receive a nose portion 101 of the handle assembly 100 therebetween. Such arrangement enables the mounting bushing 60 to rotate about longitudinal axis A-A relative to the handle assembly 100. The spine member 50 is non-rotatably pinned to the mounting bushing 60 by a spine pin 66. In addition, a rotation knob 70 is attached to the mounting bushing 60. In one embodiment, for example, the rotation knob 70 has a hollow mounting flange portion 72 that is sized to receive a portion of the mounting bushing 60 therein. In various embodiments, the rotation knob 70 may be fabricated from, for example, glass or carbon filled Nylon, polycarbonate, Ultem®, etc. and is affixed to the mounting bushing 60 by the spine pin 66 as well. In addition, an inwardly protruding retention flange 74 is formed on the mounting flange portion 72 and is configured to extend into a radial groove 68 formed in the mounting bushing 60. Thus, the surgeon may rotate the spine member 50 (and the end effector 12 attached thereto) about longitudinal axis A-A in a 360° path by grasping the rotation knob 70 and rotating it relative to the handle assembly 100.

In various embodiments, the anvil 20 is retained in an open position by an anvil spring 21 or other biasing arrangement as depicted in FIGS. 1, 9A, 10A, and 11A. The anvil 20 is selectively movable from the open position to various closed or clamping and firing positions by a firing system, generally designated as 109. The firing system 109 includes a “firing member” 110 which, in various embodiments, comprises a hollow firing tube 110. The hollow firing tube 110 is axially movable on the spine member 50 and thus forms the outer portion of the elongated shaft assembly 40. The firing tube 110 may be fabricated from a polymer or other suitable material and have a proximal end 112 that is attached to a firing yoke 114 of the firing system 109. See FIG. 4. In various embodiments for example, the firing yoke 114 may be over-molded to the proximal end 112 of the firing tube 110. However, other fastener arrangements may be employed.

As can be seen in FIGS. 1 and 4, the firing yoke 114 may be rotatably supported within a support collar 120 that is configured to move axially within the handle assembly 100. In various embodiments, the support collar 120 has a pair of laterally extending fins 122 that are sized to be slidably received within fin slots 103 and 105 formed in the right and left hand case members 102, 104, respectively. See FIG. 7. Thus, the support collar 120 may slide axially within the handle housing 100 while enabling the firing yoke 114 and firing tube 110 to rotate relative thereto about the longitudinal axis A-A. As can be seen in FIG. 4, a longitudinal slot 111 is provided through the firing tube 110 to enable the spine pin 66 to extend therethrough into the spine member 50 while facilitating the axial travel of the firing tube 110 on the spine member 50.

The firing system 109 further comprises a firing trigger 130 which serves to control the axial travel of the firing tube 110 on the spine member 50. See FIG. 1. Such axial movement in the distal direction of the firing tube 110 into firing interaction with the anvil 20 is referred to herein as “firing motion”. As can be seen in FIG. 1, the firing trigger 130 is movably or pivotally coupled to the handle assembly 100 by a pivot pin 132. A torsion spring 135 is employed to bias the firing trigger 130 away from the pistol grip portion 107 of the handle assembly 100 to an un-actuated “open” or starting position. As can be seen in FIGS. 1 and 4, the firing trigger 130 has an upper portion 134 that is movably attached to (pinned) firing links 136 that are movably attached to (pinned) the support collar 120. Thus, movement of the firing trigger 130 from the starting position (FIGS. 1 and 9) toward an ending position adjacent the pistol grip portion 107 of the handle assembly 100 (FIG. 14) will cause the firing yoke 114 and the firing tube 110 to move in the distal direction “DD”. Movement of the firing trigger 130 away from the pistol grip portion 107 of the handle assembly 100 (under the bias of the torsion spring 135) will cause the firing yoke 114 and firing tube 110 to move in the proximal direction “PD” on the spine member 50.

Various embodiments of the present invention may be employed with different sizes and configurations of implantable staple cartridges. For example, the surgical instrument 10, when used in connection with a first firing adapter 140, may be used with a 5 mm end effector 12 that is approximately 20 mm long (or in other lengths) which supports an implantable staple cartridge 30. Such end effector size may be particularly well-suited, for example, to complete relatively fine dissection and vascular transactions. However, as will be discussed in further detail below, the surgical instrument 10 may also be employed, for example, in connection with other sizes of end effectors and staple cartridges by replacing the first firing adapter 140 with a second firing adapter 150. In still other embodiments, the elongated shaft assembly 40 may configured to be attached to only one form or size of end effector. In such embodiments, for example, the pressure surfaces 146 or 158 (normally provided on the firing adapters 140, 150, respectively) would be integrally formed in the distal end of the firing tube 110—depending upon the particular size of end effector with which it is to be used.

As can be seen in FIG. 2, the first firing adapter 140 is substantially hollow and has a first spring portion 142 that is configured to extend into an open distal end 116 of the firing tube 110. A first retainer button 144 is formed on the first spring portion 142 and is sized to be received within a retaining hole 117 provided in the distal end portion of the firing tube 110. See FIGS. 1 and 2. Thus, to detach the first firing adapter 140 from the firing tube 110, the user simply depresses the retainer button 144 out of the retaining hole 117 and withdraws the first firing adapter 140 out of the firing tube 110. As can also be seen in FIG. 2, the first firing adapter 140 has an interior pressure surface 146 that is configured to interface with the bifurcated ramp assembly 24 of the anvil 20.

In various implementations, the bifurcated ramp assembly 24 on the anvil 20 comprises a pair of tines 45 that are separated by a blade-receiving groove (not shown). Each tine 45 has a proximal surface 27 that is substantially parallel to the bottom of the elongated channel 14 when the anvil 20 is in a closed position. The proximal surface 27 then transitions into a clamping ramp 28 that is distal to the proximal surface 27. See FIG. 3. The clamping ramp 28 is oriented at a clamping angle “A” with respect to the proximal surface 27. In various embodiments, for example, clamping angle “A” may be approximately 15 to 30 degrees. As will be discussed in further detail below, when the first pressure surface 146 of the first firing adapter 140 contacts the clamping ramp 28, the anvil 20 will be moved toward the elongated channel 14 and more specifically toward the staple cartridge 30 therein. As the first firing adapter 140 is further moved distally, the first pressure surface 146 contacts a staple forming ramp 29 on each of the anvil tines 45 to further drive the anvil 20 into the staple cartridge 30 to form the staples 32 therein. As is also shown in FIG. 3, the staple forming ramp 29 is oriented at a forming angle “B” relative to the clamping ramp 27. In various embodiments, for example, forming angle “B” may be approximately 5 to 20 degrees. The ramp assembly 24 of the anvil 20 may further have a sloped under surface 25 thereon (e.g., angle “C” is approximately 5 to 40 degrees) such that when the anvil 20 is in an open position, the sloped undersurface 25 surface enables the anvil 20 to pivot to a 15° open limit (angle “β” in FIG. 11A).

One method of removably coupling the end effector 12 to the spine member 50 will now be explained. The coupling process is commenced by inserting the retention trunions 17 on the elongated channel 14 into the trunion cradles 52 in the spine member 50. Thereafter, the surgeon advances the firing trigger 130 toward the pistol grip 107 of the housing assembly 100 to distally advance the firing tube 110 and the first firing adapter 140 over a proximal end portion 47 of the elongated channel 14 to thereby retain the trunions 17 in their respective cradles 52. See FIGS. 10 and 10A. Such position of the first firing adapter 140 over the trunions 17 is referred to herein as the “coupled position”. Various embodiments of the present invention may also have an end effector locking assembly 160 for locking the firing trigger 130 in position after an end effector 12 has been attached to the spine member 50.

More specifically and with reference to FIGS. 5, 7, and 8, one embodiment of the end effector locking assembly 160 includes a retention pin 162 that is movably supported in the upper portion 134 of the firing trigger 130. The retention pin 162 is spring-biased toward the left hand case member 104 by a retention spring 166. When the firing trigger 130 is in an un-actuated (starting) position, the retention pin 162 is biased into abutting contact with a start detent 163 that protrudes inwardly from the left hand case member 104. See FIGS. 7 and 8. As discussed above, the firing tube 110 must initially be advanced distally to the coupled position wherein the first firing adapter 140 retains the retention trunions 17 of the end effector 12 in the trunion cradles 52 in the spine member 50. The surgeon advances the firing adapter 140 distally to the coupled position by pulling the firing trigger 130 from the starting position toward the pistol grip 107. As the firing trigger 130 is initially actuated, the retention pin 162 slides in abutting contact with the start detent 163 until the firing tube 110 has advanced the first firing adapter 140 to the coupled position at which point the retention pin 162 is biased into a locking cavity 164 formed in the left hand case member 104. See FIG. 8. In various embodiments, when the retention pin 162 enters into the locking cavity 164, the pin 162 may make an audible “click” or other sound, as well as provide a tactile indication to the surgeon that the end effector 12 has been “locked” onto the spine member 50. In addition, the surgeon cannot inadvertently continue to actuate the firing trigger 130 to start to form staples 32 in the end effector 12 without intentionally biasing the retention pin 162 out of the locking cavity 164. Similarly, if the surgeon releases the firing trigger 130 when in the coupled position, it is retained in that position by the retention pin 162 to prevent the firing trigger 130 from returning to the starting position and thereby releasing the end effector 12 from the spine member 50.

In various implementations, a firing trigger release button 167 is mounted within the left hand case member 104 of the handle assembly 100 to enable the surgeon to intentionally release the retention pin 162 to enable the firing trigger 130 to be further actuated or returned to the starting position. See FIGS. 5, 7, and 8. The firing trigger release button 167 is movably mounted within the locking cavity 164 and is spring-biased to an un-activated position (FIG. 8). When the firing trigger release button 167 is pressed inwardly, it contacts the retention pin 162 and moves it out of the locking cavity 163 to enable the firing trigger 130 to be further activated.

As thus far described, the surgical instrument 10 may be used as a grasping device to manipulate/position tissue. Further movement of the firing trigger 130 toward the pistol grip portion 107 after the trigger 130 has been unlocked (by depressing the retention release button 167) will cause the firing adapter 140 to contact the clamping ramp 28 on the anvil 20. As the pressure surface portion 146 of the first firing adapter rides up the clamping ramp 28, the anvil will move towards the staple cartridge 30 in the elongated channel 14. Thus, the surgeon may manipulate the anvil 20 toward and away from the staple cartridge 30 to grasp and release tissue therebetween without forming the staples.

Various embodiments of the present invention may further include a firing system lock button 137 that is pivotally attached to the handle assembly 100. See FIGS. 1 and 4. In one form, the firing system lock button 137 has a latch 138 formed on a distal end thereof that is oriented to engage the firing yoke 114 when the firing release button is in a first latching position. As can be seen in FIGS. 1 and 4, a latch spring 139 serves to bias the firing system lock button 137 to the first latching position (FIGS. 11 and 12). As will be explained in further detail below, the latch 138 serves to engage the firing yoke 114 at a point where the position of the firing yoke 114 on the spine member 50 corresponds to a point wherein the pressure surface 146 of the first firing adapter 140 is about to distally advance up the clamping ramp 28 on the anvil 20. It will be understood that, as the first firing adapter 140 advances axially up the clamping ramp 28, the anvil 20 will move in a path such that its staple forming surface portion 22 is substantially parallel to the upper face 36 of the staple cartridge 30.

After the end effector 12 has been coupled to the spine member 50, the staple forming process is commenced by first depressing the firing system lock button 137 to enable the firing yoke 114 to be further moved distally on the spine member 50 and ultimately compress the anvil 20 into the staple cartridge 30. See FIG. 13. After depressing the firing system lock button 137, the surgeon continues to actuate the firing trigger 130 towards the pistol grip 107 thereby driving the pressure surface 146 of the first staple collar 140 up the corresponding staple forming ramp 29 to force the anvil 20 into forming contact with the staples 32 in the staple cartridge 30. The firing system lock button 137 prevents the inadvertent forming of the staples 32 until the surgeon is ready to start that process. In this embodiment, the surgeon must depress the firing system lock button 137 before the firing trigger 130 may be further actuated to begin the staple forming process.

The surgical instrument 10 may be solely used as a tissue stapling device if so desired. However, various embodiments of the present invention may also include a tissue cutting system, generally designated as 170. In at least one form, the tissue cutting system 170 comprises a knife member 172 that may be selectively advanced from an un-actuated position adjacent the proximal end of the end effector 12 (FIGS. 1 and 9-13) to an actuated position (FIG. 14) by actuating a knife advancement trigger 200. The knife member 172 is movably supported within the spine member 50 and is attached or otherwise protrudes from a knife rod 180. The knife member 172 may be fabricated from, for example, 420 or 440 stainless steel with a hardness of greater than 38HRC (Rockwell Hardness C-scale) and have a tissue cutting edge 176 formed on the distal end 174 thereof and be configured to slidably extend through a slot 31 in the anvil 20 and a centrally disposed slot 33 in the staple cartridge 30 to cut through tissue that is clamped in the end effector 12. See FIG. 14A. As can be seen in FIG. 4, the knife rod 180 extends through the spine member 50 and has a proximal end portion 182. The proximal end portion 182 drivingly interfaces with a knife transmission 190 that is operably attached to the knife advance trigger 200. In various embodiments, the knife advance trigger 200 is attached to pivot pin 132 such that it may be pivoted or otherwise actuated without actuating the firing trigger 130. In various embodiments, a first knife gear 192 is also attached to the pivot pin 132 such that actuation of the knife advance trigger 200 also pivots the first knife gear 192. A firing return spring 202 is attached between the first knife gear 192 and the handle housing 100 to bias the knife advancement trigger 200 to a starting or un-actuated position. See FIGS. 1 and 4.

Turning to FIGS. 5 and 6, various embodiments of the knife transmission 190 also include a second knife gear 194 that is rotatably supported on a second gear spindle 193 and in meshing engagement with the first knife gear 192. The second knife gear 194 is in meshing engagement with a third knife gear 196 that is supported on a third gear spindle 195. Also supported on the third gear spindle 195 is a fourth knife gear 198. The fourth knife gear 198 is adapted to drivingly engage a series of annular gear teeth or rings 184 on a proximal end of the knife rod 180. Thus, such arrangement enables the fourth knife gear 198 to axially drive the knife rod 180 in the distal direction “DD” or proximal direction “PD” while enabling the firing rod 180 to rotate about longitudinal axis A-A with respect to the fourth knife gear 198. Accordingly, the surgeon may axially advance the firing rod 180 and ultimately the knife member 172 distally by pulling the knife advancement trigger 200 towards the pistol grip 107 of the handle assembly 100.

Various embodiments of the present invention further include a knife lockout system 210 that prevents the advancement of the knife member 72 unless the firing trigger 130 has been pulled to the fully fired position (FIGS. 13 and 14). Such feature will therefore prevent the activation of the knife advancement system 170 unless the staples have first been fired or formed into the tissue. As can be seen in FIG. 1, various implementations of the knife lockout system 210 comprise a knife lockout bar 211 that is pivotally supported within the pistol grip portion 107 of the handle assembly 100. The knife lockout bar 211 has an activation end 212 that is adapted to be engaged by the firing trigger 130 when the firing trigger 130 is in the fully fired position. In addition, the knife lockout bar 211 has a retaining hook 214 on its other end that is adapted to hookingly engage a latch rod 216 on the first cut gear 192. A knife lock spring 218 is employed to bias the knife lockout bar 211 to a “locked” position wherein the retaining hook 214 is retained in engagement with the latch rod 216 to thereby prevent actuation of the knife advancement trigger 200 unless the firing trigger 130 is in the fully fired position. See FIG. 9.

Various methods of operating at least one of the surgical instrument embodiments of the present invention will now be explained with reference to FIGS. 9, 9A, 10, 10A, 11, 11A, 12, 12A, 13, 13A, 14, and 14A. As can be appreciated from reference to FIGS. 1, 9 and 9A, when the knife bar 172 is in the depicted “starting” or un-actuated position, the tissue cutting edge 176 is proximal to the distal end of the first firing adapter 140 such that the sharp tissue cutting edge 176 is not exposed to the user. In alternative embodiments, wherein the elongated shaft assembly is manufactured for use with a single form or size of end effector (e.g., wherein the firing adapters 140, 150 are not employed), the cutting edge 176 of the knife bar 172 would be located proximal to the distal end of the firing tube to prevent the tissue cutting edge 176 from being exposed to the user in those embodiments as well.

FIGS. 9 and 9A illustrate the end effector 12 after it has been attached to the spine member 50 by inserting the retention trunions 17 on the end effector 12 into the trunion cradles 52 in the spine member 50. As illustrated in FIG. 9, the firing trigger 130 is in an un-actuated or starting position and the end effector 12 has not yet been locked to the spine member 50 by the first firing adapter 140. “Po” represents the distance that the firing trigger 130 can travel before the first firing adapter 140 starts to travel up the clamping ramp portion 28 of the anvil 20. The knife advancement trigger 200 is also in a locked un-actuated position.

FIGS. 10 and 10A illustrate the position of the firing trigger 130 after it has been advanced to a position wherein the end effector 12 is been locked to the spine member 50 by the first firing adapter 40. This position is referred to herein as the “coupled” position. When in the coupled position, the retention pin 162 has snapped into the locking cavity 164 (FIG. 8) to thereby provide the surgeon with an audible and tactile indication that the end effector 12 is now locked to the spine member 50. The firing trigger 130 cannot be actuated further until the surgeon intentionally depresses the firing trigger release button 167 (FIGS. 5, 7, and 8) to bias the retention pin 62 out of the locking cavity 164. The distance that the distal end 141 of the first firing adapter 140 has traveled is represented as distance “l” (FIG. 10A) and the corresponding distance that the firing yoke 114 has traveled on the spine member 50 is represented as distance “l′”. FIGS. 11 and 11A illustrate a position of the firing trigger 130 after the release button (not shown) has been depressed and the surgeon has activated the firing trigger 130 to move the first firing adapter 140 to the beginning of the clamping ramps 28 on the anvil 20. As can be seen in those Figures, the anvil spring 21 has biased the anvil 20 to an open position. The travel of the distal end of the first firing adapter 140 is represented as distance “l1” and the corresponding distance that the firing yoke 114 has traveled on the spine member 50 is represented as distance “l′1”. FIGS. 12 and 12A illustrate the position of the first firing adapter 140 after it has been advanced to the start of the staple forming ramp 29 of the anvil 20. This position represents the maximum amount of clamping that can be attained before staple formation begins. This position is referred to herein as a “maximum clamped position”. As can be seen in FIG. 12, the firing yoke 114 has contacted the latch 138 on the firing trigger release button 137 and therefore cannot be further advanced distally until the firing trigger release button 137 has been depressed. As can be seen in FIG. 12A, the staple forming surface 22 of the anvil 20 is substantially parallel to the upper face 31 of the staple cartridge 30. The distance between the staple forming portion 22 of the anvil 20 and the top retaining surface of the elongated channel 14 has been represented as “Cmax”. In various embodiments, Cmax may be, for example, 0.085 to 0.144 inches (approximately 2.15 to 3.65 mm) for staple cartridges 30 with body portions 31 that have a substantially equivalent thickness. In at least one embodiment, for example, the cartridge thickness may be as much as approximately 0.01 to 0.03 inches (approximately 0.25 mm to 0.76 mm) larger than the staple size. The total distance that the first firing adapter 140 has traveled from the starting position to this maximum clamped position is represented as “l2” and the corresponding distance that the firing yoke 114 has traveled on the spine member 50 is represented as “l′2”. FIGS. 13 and 13A illustrate the position of the firing yoke 114 in a fully fired position wherein the staples 32 in the staple cartridge 30 have been fully formed. When in that position, the distance between the staple forming portion 22 of the anvil 20 and the top retaining surface of the elongated channel 14 is represented as “Cmin”. In various embodiments, “Cmin” may be, for example, approximately 0.015 to 0.030 inches (approximately 0.38 mm to 0.76 mm) for staple cartridges that support staples that, when unformed, have legs that are approximately 0.075 to 0.134 inches (approximately 1.90 mm to 3.40 mm) long (distance “UF” in FIG. 1A) and when fully formed have a fully formed height of, for example, approximately 0.025 inches to 0.04 inches (approximately 0.63 mm to 1.01 mm) which comprises distance “FF” in FIG. 1D. The total distance that the first firing adapter 140 has traveled from the starting position to this fully fired position is represented as “l3” and the corresponding distance that the firing yoke 114 has traveled on the spine member 50 is represented as “l′3”. As can also be seen in FIG. 13, the firing trigger 130 is in the fully fired position and has contacted the activation end 212 of the knife lockout bar 211 to bias the retaining hook 214 out of engagement with the latch rod 216 on the first cut gear 192.

Transection, especially of vessels may be one of the highest stress steps of any surgical procedure. In the laparoscopic environment, it is even more stressful because if something fails, the entire procedure may need to be converted to an open procedure almost immediately in order to prevent catastrophic events from occurring. Thus, it may be desirable to employ a surgical stapling instrument that has the ability to optionally cut tissue after the staples have been deployed. Various embodiments of the present invention meet such needs.

After the staples have been “fired” (formed) into the target tissue, the surgeon may depress the firing trigger release button 167 to enable the firing trigger 130 to return to the starting position under the bias of the torsion spring 135 which enables the anvil 20 to be biased to an open position under the bias of spring 21. When in the open position, the surgeon may withdraw the end effector 12 leaving the implantable staple cartridge 30 and staples 32 behind. In applications wherein the end effector was inserted through a passage, working channel, etc. the surgeon will return the anvil 20 to the closed position by activating the firing trigger 130 to enable the end effector 12 to be withdrawn out through the passage or working channel. If, however, the surgeon desires to cut the target tissue after firing the staples, the surgeon activates the knife advancement trigger 200 in the above-described manner to drive the knife bar 72 through the target tissue to the end of the end effector as shown in FIGS. 14, 14A. FIG. 14 illustrates the amount of travel of the knife advancement trigger 200 in various embodiments for different lengths of end effectors/staple cartridges wherein the knife bar 72 has been advanced to the fully fired position within the end effector 12. Thereafter, the surgeon may release the knife advancement trigger 200 to enable the firing return spring 202 to cause the firing transmission to return the knife bar 72 to the starting (un-actuated) position (FIGS. 13, 13A). Once the knife bar 72 has been returned to the starting position, the surgeon may open the end effector jaws 13, 15 to release the implantable cartridge 30 within the patient and then withdraw the end effector 12 from the patient. Thus, such surgical instruments of the present invention facilitate the use of small implantable staple cartridges that may be inserted through relatively smaller working channels and passages, while providing the surgeon with the option to fire the staples without cutting tissue or if desired to also cut tissue after the staples have been fired.

As indicated above, the surgical instrument 10 can be employed in connection with other end effectors that support other sizes of staple cartridges that contain other sizes and numbers of staples. FIGS. 15-19 illustrate use of an end effector 12′ which operably supports a staple cartridge 30′ that has staples 32′ that are larger than the staples 32 in the staple cartridge 30. For example, the staples 32 in a staple cartridge 30 may be approximately 0.080-0.085 inches (approximately 2.03 to 2.15 mm staples, whereas the staples 32′ in the staple cartridge 30′ may be approximately 0.075 inches (approximately 1.90 mm). In various embodiments, the staple cartridge 30′ is longer than the staple cartridge 30. For example, the staple cartridge 30 may be approximately 0.78 inches (approximately 20 mm) long; whereas the staple cartridge 30′ may be approximately 1.57 inches (approximately 40 mm) long. FIG. 15 is an exploded view of an end effector 12′, a second firing adapter 150 and the distal end 55 of the spine member 50. As can be seen in FIG. 15, the elongated channel 14′ has a pair of spaced side walls 16′ that each has a slot or opening 18′ therein that is sized to receive a corresponding anvil pin 26′. The anvil 20′ and the elongated channel 14′ may together form an end effector 12′ that has an overall diameter that would permit the end effector 12′ to pass through an opening that has a diameter of at least approximately 0.20 inches (approximately 5.0 mm). The anvil 20′ also has a staple forming portion 22′ that has a plurality of staple forming pockets formed therein and a bifurcated ramp assembly 24′ that protrudes proximally therefrom. The proximal end 15′ of the elongated channel 14′ has a pair of retention trunions 17′ protruding therefrom that are sized to be received within corresponding trunion cradles 52 that are provided in the spine member 50.

As can be seen in FIG. 15, the second firing adapter 150 has a substantially hollow body portion 151 and a proximal collar portion 152 that has an inwardly extending retaining protrusion 154 therein. A slot 156 is provided between the body portion 151 and the proximal collar portion 152 to enable the collar portion 152 to be biased relative to the body portion 151 to facilitate the insertion of the retaining protrusion 154 into the retaining hole 117 in the firing tube 110. To detach the second firing adapter 150 from the firing tube 110, the surgeon depresses the proximal collar portion 152 to move the retaining protrusion 154 out of the retaining hole 117 to thereby enable the second firing adapter 150 to be pulled distally off of the firing tube 110.

In various embodiments, the anvil 20′ has a bifurcated ramp assembly 24′ that comprises a pair of tines 45′ that each has a proximal surface 27′ that transitions into a clamping ramp 28′ that is distal to the proximal surface 27′. See FIG. 15. The clamping ramp 28′ is oriented at an angle “A′” with respect to the proximal surface 27′. In various embodiments, for example, angle “A′” may be approximately 50 to 30 degrees. As will be discussed in further detail below, when a second pressure surface 158 of the second firing adapter 150 contacts the clamping ramps 28′, the anvil 20′ will be moved toward the elongated channel 14′ and more specifically toward the staple cartridge 30′ therein. See FIG. 17. As the second firing adapter 150 is further moved distally, the second pressure surface 158 contacts staple forming ramps 29′ on the anvil tines 45 to further drive the anvil 20′ toward the staple cartridge 30′ to form the staples 32′ therein. See FIG. 18. The staple forming ramp 29′ is oriented at an angle “B′” relative to the clamping ramp 27′. In various embodiments, for example, angle “B′” may be approximately 5 to 20 degrees. A spring (not shown) may be provided between the ramp assembly 24′ and the bottom of the elongated channel 14′ to bias the anvil 20′ to that open position.

FIG. 16 shows the position of the second firing adapter 150 after the surgeon has distally advanced the second firing adapter 150 to the start of the clamping ramp portions 28′. Operation of the second firing adapter 150 is controlled by the firing trigger 130 in the manner described above with respect to the first firing adapter 140. FIG. 17 illustrates the position of the second firing adapter 150 in a fully clamped position. FIG. 18 illustrates the position of the second firing adapter 150 in the fully fired position wherein the staples 32′ in the staple cartridge 30′ have been formed through the clamped tissue (not shown).

As indicated above, the implantable staple cartridge 30′ is longer than the implantable staple cartridge 30. Thus, as shown in FIG. 15, the end effector 12′ also includes a distal knife member 124 that is movably supported in the elongated channel 14′. The distal knife member 124 has a tissue cutting edge 125 and a proximal portion 126 that is configured for engagement by the knife bar 72. Thus, if the surgeon desires to cut the tissue after the staples have been fired, the surgeon activates the firing trigger 200 as described above to drive the knife bar 172 distally into contact with the distal knife member 124 to drive the distal knife member 124 through the tissue as illustrated in FIG. 19. The distal knife member 124 may have at least one retainer portion thereon that is adapted to slide through a correspondingly shaped slot (not shown) in the elongated channel 14′. Such arrangement enables the end effector 12′ to be opened after the staples have been formed and the tissue has been cut. The distal knife member 124 remains in the anvil 20′ and is removed with the end effector 12′ when it is withdrawn from the patient.

Thus, various embodiments of the surgical instrument 10 have separate stapling and tissue cutting mechanisms such that the surgeon may staple the tissue without cutting the tissue. The various embodiments of the stapling instrument of the present invention can be successfully employed with different sizes of end effectors that are adapted to fire different sizes and numbers of staples. The surgical instruments may be provided in the form of a kit that includes an instrument 10 and a first firing adapter 140 and a second firing adapter 150 that enables the instrument to be employed to fire different sizes of implantable staple cartridges.

Various unique and novel embodiments of the present invention employ a compressible staple cartridge that supports staples in a substantially stationary position for forming contact by the anvil. Unlike prior surgical stapling arrangements that employ staple driving elements, the staples in the cartridges of various embodiments of the present invention are not driven into the anvil. In the various embodiments of the present invention, the anvil is driven into the unformed staples. The degree of staple formation attained is dependent upon how far the anvil is driven into the staples. Such arrangement provides the surgeon with the ability to adjust the amount of forming or firing pressure applied to the staples and thereby alter the final formed height of the staples.

In various embodiments, the amount of firing motion that is applied to the movable anvil is dependent upon the degree of actuation of the firing trigger. For example, if the surgeon desires to attain only partially formed staples, then the firing trigger is only partially depressed inward towards the pistol grip 107. To attain more staple formation, the surgeon simply compresses the firing trigger further which results in the anvil being further driven into forming contact with the staples. As used herein, the term “forming contact” means that the staple forming surface or staple forming pockets have contacted the ends of the staple legs and have started to form or bend the legs over into a formed position. The degree of staple formation refers to how far the staple legs have been folded over and ultimately relates to the forming height of the staple as referenced above. Those of ordinary skill in the art will further understand that, because the anvil 20 moves in a substantially parallel relationship with respect to the staple cartridge as the firing motions are applied thereto, the staples are formed substantially simultaneously with substantially the same formed heights.

FIGS. 20-23 illustrate an alternative surgical instrument 10 that employs a staple height indicator assembly 220. In various embodiments, the staple height indicator assembly 220 comprises an indicator bar 222 that is attached to the upper portion 134 of the firing trigger 130 for pivotal travel therewith. As the firing trigger 130 is pivoted toward the pistol portion 107 of the handle assembly 100 to compress the anvil 20 into the staple cartridge 30 as described above, the indicator bar 222 is viewable through a window 223 in the left hand case member 104. In this embodiment, the staple height indicator assembly 220 also includes a series of detents 24, 26, 28 that are formed in the left hand case member 104 and which correspond to three stages of staple formation. In particular, once the firing trigger 130 is initially actuated, the retention pin 162 slides in abutting contact with the start detent 163 until the firing tube 110 has advanced the firing adapter 140 or 150 to the above-described locking position at which point the retention pin 162 is biased into a locking cavity 164 formed in the left hand case member 104. When the surgeon desires to start to close the jaws 13, 35 of the end effector 12, the retention release button 167 is depressed to enable the firing trigger 130 to be further actuated. When the firing trigger release button 167 is pressed inwardly, it contacts the retention pin 162 and moves it out of the locking cavity 163 to enable the firing trigger 130 to be activated. As described above, the surgeon may now use the bottom and top jaws 13, 15, respectively of the end effector 12 to grasp and manipulate tissue. When the surgeon desires to commence the staple forming process, the firing trigger release button 167 is depressed which enables the firing yoke 114 to be advanced distally as the surgeon continues to depress the firing trigger 130.

Further advancement of the firing trigger 130 moves the anvil 20 into forming contact with the staples 32 in the staple cartridge 30. As the firing trigger 130 is further depressed, the flat end 165 of the retention pin 162 will slide off of starting detent 163 and contact the first detent 224 that corresponds to a first amount of staple formation that is represented by a first staple height symbol 230 on the left hand case member 104. See FIG. 20. As shown, the first staple height symbol 230 comprises a picture of a staple that has just started to form. Other symbols/indicia could be used to designate this stage of staple formation. As the retention pin 162 engages the first detent 224 and audible click may be heard by the surgeon. The engagement of the retention pin 162 with the first detent 224 may also provide some tactile feedback to the surgeon through the firing trigger 130. In addition, the staple height indicator bar 222 may be viewed through the viewing window 223 adjacent to the first height staple symbol 230. If the surgeon desires to further form the staples 32 in the staple cartridge, the retention pin 162 is pressed out of engagement with the first detent 224 by a release button 240 that is formed into the second hand case member 104. In various embodiments for example, the release button 240 may be integrally formed into the left hand case member 104 with a hinge portion 242 that is part of the left hand case member 104. Such arrangement enables the release button 240 to be pressed into the end 165 of the retention pin 162 to move it out of engagement with any of the first, second and third detents 224, 226, 228. Once the retention pin 162 has been pressed out of the first detent 224, the firing trigger 130 may be further depressed until the retention pin 162 engages the second staple formation detention 226. Such position of the firing trigger 130 has resulted in further movement of the anvil 20 into staple forming contact with the staples 32 in the staple cartridge 30. Again, the retention pin 162 snaps into the second staple formation detent 226 providing the surgeon with audible and tactile feedback that the firing trigger 130 is in the second staple formation position. When in that position, the staple height indicator bar 222 may be viewed through the viewing window 223 and is adjacent to the second staple height symbol 232. If the surgeon desires to further form the staples 32 in the staple cartridge 30, the retention pin 162 is pressed out of engagement with the second detent 226 by depressing the release button 240. Thereafter, the firing trigger 130 may be depressed further until the retention pin 162 engages the third staple formation detent 228 corresponding to the final stage of staple formation. Again, the retention pin 162 snaps into the third staple formation detent 228 providing the surgeon with audible and tactile feedback that the firing trigger 130 is in the third staple formation position. When in that position, the staple height indicator bar 222 may be viewed through the viewing window 223 and is adjacent to the staple height symbol 234. After the staples have been formed a desired amount, the surgeon may bias the retention pin 162 out of the third staple height detent 228 to enable the firing trigger 130 to return to the starting position. Or, if desired, the surgeon may then commence the tissue cutting procedure as described above before returning the firing trigger 130 to the starting position.

FIG. 24 illustrates an alternative embodiment wherein the staple height indicator assembly, generally designated as 220′, does not include the series of detents that correspond to the various staple formations. This embodiment, however, does include the staple height indicator bar 222 and viewing window 223. Thus, the surgeon may monitor the amount of staple formation being achieved by monitoring the position of the staple height indicator bar 222 through the viewing window 223. This embodiment does include the staple height indicator symbols 230, 232, 234 as described above. In addition, this embodiment may also include an unformed staple symbol 229 that corresponds to the starting position wherein the staples 32 have not yet started to be formed by the anvil 20. This embodiment would otherwise operate in the same manners described above.

FIGS. 25 and 26 illustrate an alternative end effector 12″ that is similar to the end effector 12′ described above, except with the following differences that are configured to accommodate a knife bar 172′. The knife bar 172′ is coupled to or protrudes from a knife rod 180 and is otherwise operated in the above described manner with respect to the knife bar 172. However, in this embodiment, the knife bar 172′ is long enough to traverse the entire length of the end effector 12″ and therefore, a separate distal knife member is not employed in the end effector 12″. The knife bar 172′ has an upper transverse member 173′ and a lower transverse member 175′ formed thereon. The upper transverse member 173′ is oriented to slidably transverse a corresponding elongated slot 250 in anvil 20″ and the lower transverse member 175′ is oriented to traverse an elongated slot 252 in the elongated channel 14″ of the end effector 12″. A disengagement slot (not shown) is also provide din the anvil 20″ such that when the knife bar 172′ has been driven to an ending position with thin end effector 12″, the upper transverse member 173′ drops through the corresponding slot to enable the anvil 20″ to move to the open position to disengage the stapled and cut tissue. The anvil 20″ may be otherwise identical to anvil 20 described above and the elongated channel 14″ may be otherwise identical to elongated channel 14 described above.

In these embodiments, the anvil 20″ is biased to a fully open position (FIG. 25) by a spring or other opening arrangement (not shown). The anvil 20″ is moved between the open and fully clamped positions by the axial travel of the firing adapter 150 in the manner described above. Once the firing adapter 150 has been advanced to the fully clamped position (FIG. 26), the surgeon may then advance the knife bar 172″ distally in the manner described above. If the surgeon desires to use the end effector as a grasping device to manipulate tissue, the firing adapter may be moved proximally to allow the anvil 20″ to move away from the elongated channel 14″ as represented in FIG. 27 in broken lines. In this embodiment, as the knife bar 172″ moves distally, the upper transverse member 173′ and the lower transverse member 175′ draw the anvil 20″ and elongated channel 14″ together to achieve the desired staple formation as the knife bar 172″ is advanced distally through the end effector 12″. See FIG. 28. Thus, in this embodiment, staple formation occurs simultaneously with tissue cutting, but the staples themselves may be sequentially formed as the knife bar 172″ is driven distally.

FIGS. 29 and 30 illustrate use of an end effector 12″ that has an anvil 20″ that is fabricated from, for example, stainless steel, titanium, PGA (Polyglycolic acid) or other absorbable plastic and is somewhat flexible. These Figures also illustrate use of a retention matrix 6250 and an alignment matrix 6206 which will be discussed in further detail below. As can be seen in FIG. 29, the anvil 20″ flexes into the fully formed position as the knife bar 172″ is driven distally therethrough.

In many surgical applications, it is desirable or advantageous to employ a surgical cutting and stapling instrument that has an end effector that may be articulated relative to the elongated shaft assembly. The ability to access tight areas with prior articulatable instruments, however, was often times limited due to the size and construction of the members used to effect articulation of the end effector. FIGS. 31-40 illustrate another surgical instrument embodiment of the present invention that is capable of articulating the end effector relative to the elongated shaft and which employs a relatively compact articulation control arrangement in the handle assembly.

The surgical instrument 310 of this embodiment is substantially similar to the various surgical instrument embodiments 10 described above, except that this embodiment employs an articulated shaft assembly 312 to facilitate selective positioning of the end effector 12 relative to the elongated longitudinal axis A-A. While the surgical instrument 310 will be described herein for use in connection with an end effector 12 of the type described above, those of ordinary skill in the art will appreciate that the surgical instrument 310 may also be employed in connection with a second firing adapter 150 to actuate an end effector 12′ or other end effector arrangements. As can be seen in FIGS. 31 and 32, the articulated shaft assembly 312 includes a distal shaft assembly portion 314 that is pivotally coupled to a proximal shaft assembly portion 316 that is operably coupled to the handle assembly 100. In various embodiments, for example, the distal shaft assembly 314 includes a distal spine member 320 that has a pair of trunion cradles 322 therein for receiving the trunions 17 therein. See FIG. 32. The distal spine member 320 has a proximal end 324 that includes a pivot base 326 that has a pivot pin 328 protruding therefrom.

As can be seen in FIG. 32, the proximal shaft assembly portion 316 includes a proximal spine segment 330 that has a proximal pivot base and knife guide 332 attached thereto. The knife guide 332 may, for example, be welded or attached to the proximal spine segment 330 with adhesive or other fastener arrangements. A pivot hole 334 is provided in the proximal pivot base knife guide 332 to rotatably receive the pivot pin 328 therein to enable the distal spine segment 320 to pivot relative to the proximal spine segment 330 about a first pivot axis FA-FA that is substantially transverse to the longitudinal axis A-A. The surgical instrument 310 further includes a distal firing tube segment 370 that is pivotally coupled to a pair of firing tube links 380, 382 for pivotal travel about a second axis SA-SA. The distal firing tube segment 370 has a retainer hole 372 for receiving the retainer button 144 of the first firing adapter 140 therein. The pair of firing tube links 380, 382 are pivotally coupled to a proximal firing tube 390 for pivotal travel relative thereto about a third pivot axis TA-TA. See FIG. 32.

In various embodiments, the proximal firing tube 390 is attached to a rotation knob 400 that is rotatably attached to the handle assembly 100. See FIGS. 31, 38 and 39. The rotation knob 400 may be molded from a polymer or plastic material and include a hub portion 402 and flange portion 404 that is spaced from the hub portion 402. A nose portion 101 of the handle assembly 100 is received between the hub portion 402 and the flange portion 404 to enable the rotation knob 400 to be rotatable relative to the handle assembly 100 about longitudinal axis A-A. In other embodiments, the rotation knob 400 may be fabricated from other suitable materials. In the depicted embodiment, the proximal firing tube 390 and the proximal spine segment 330 are each non-movably attached to the rotation knob 400. As can be seen in FIGS. 38 and 39, the proximal spine segment 330 and the proximal firing tube 390 are pinned to the rotation knob 400 by a pin 406. Thus, the surgeon may rotate the end effector 12 relative to the handle housing 100 in a 360° path about the longitudinal axis A-A by rotating the rotation knob 400.

Referring to FIGS. 37, 38 and 40, in various embodiments, the end effector 12 may be selectively articulated relative to the longitudinal axis A-A by a pair of articulation members 420, 430 that are attached to the distal pivot base 326 and an articulation ball 440 that is rotatably supported within a socket 408 in the rotation knob 400. In various embodiments, the articulation members 420, 430 may comprise, for example, cables that are fabricated from multiwire cable, Nitinol, titanium, etc. The first or right articulation member 420 has a distal end 422 that has a lug 424 formed thereon that is sized to be press-fit into a first cable attachment hole 327 that is provided in the distal pivot base 326. Likewise, the second or left articulation member 430 has a distal end 432 that has a lug 434 formed thereon that is sized to be press-fit into a second cable attachment hole 329 that is provided in the distal pivot base 326. See FIG. 37. Thus, the end effector 12 may be pivoted to the right about first axis FA-FA (FIGS. 35 and 36) by pulling on the first or right articulation member 420 and the end effector 12 may be pivoted to the left about first axis FA-FA by pulling the second or left articulation member 430. In various embodiments, the right articulation member 420 may be slidably received within a right cable channel 336 formed in the proximal spine segment 330 and the left articulation member 430 may be slidably received within a left cable channel 338 in the proximal spine segment 330.

Turning to FIGS. 38-40, the first articulation member 420 has a proximal end 426 that has a retaining ball 428 swaged thereon or otherwise attached thereto that is adapted to be received within a first retaining slot 442 in the articulation ball 440 that is rotatably supported within a socket 401 in the rotation knob 400. Likewise, the second articulation member 430 has a proximal end 436 that has a retaining ball 438 swaged thereon or otherwise attached thereto that is adapted to be received within a second retaining slot 444 in the articulation ball 440. As can be most particularly seen in FIG. 40, the articulation ball 440 further has an actuator slot 446 therethrough that facilitates the unimpeded passage of the proximal firing tube segment 390 therein. As shown in FIG. 38, the actuator slot 446 may taper from wider opening portions 448, 450 to a passage 452 in the center of the articulation ball 440 that permits sliding passage of the proximal firing tube segment 390. As will be discussed further below, the articulation ball 440 is rotatably or pivotally supported within the socket 401 and is selectively movable from a neutral position (shown in FIG. 38 in solid lines) to first and second articulation control positions (shown in FIG. 38 in broken lines). The articulation ball 440 is also axially movable within the socket 401.

As can be seen in FIG. 40, the surgical instrument 310 may include a locking arrangement, generally designated as 453 for locking the articulation ball 440 in any one of the neutral, first and second articulation control positions. In various embodiments, the locking arrangement 453 comprises a series of locking detent segments 454 that are provided on the articulation ball 440 and are adapted to mate with locking ribs 410 that are formed within a recessed 408 formed in a hub portion 402 oriented within the socket area 401 of the rotation knob 400. An actuator passage 412 extends through the hub portion 402 and aligns with the actuator slot 446 in the articulation ball 440 to accommodate the proximal firing tube segment 390 therethrough. As can be seen in FIGS. 38 and 39, an actuator ball spring 456 is journaled on a spring retention hub 414 portion of the rotation knob 400 to it bias the articulation ball 440 proximally such that the locking detents 454 are brought into retaining engagement with the locking ribs 410 in the hub portion 402.

To facilitate application of articulation motions to the articulation ball 440, a pair of laterally extending articulation handles 458, 460 protrude from the articulation ball 440 in diametrically opposite directions. In various embodiments, the articulation ball 440 may be fabricated from, for example, polycarbonate, Nylon, Ultem®, with no fill, glass fill, carbon fill, mineral fill, etc. and have the locking detents 454 machined or molded thereon. The articulation handles 458, 460 may be attached to the articulation ball 440 by press fits, welds, etc. Such locking arrangement enables the articulation ball 440 to be locked in any of the neutral or first or second articulation positions. Once the surgeon has moved the articulation ball 440 to achieve the desired articulated position of the end effector, the surgeon may release the articulation ball 440 to enable the actuator ball spring 456 to bias the articulation ball 440 proximally such that the locking detents 454 are brought into retaining engagement with the locking ribs 410 in the hub portion 402. In various embodiments, the actuator ball spring 456 may be sized such that the articulation ball 440 may spring back to the neutral position when the articulated end effector is forcibly pulled back through a trocar or similar opening. Furthermore, use of the articulation handles 458, 460 enable the degree of articulation to be “tuned” to the particular surgical application.

As can be seen in FIG. 38, the first or right articulation handle 458 protrudes through a right slot 416 in the rotation knob 400 and the second or left articulation handle 460 protrudes through a left slot 418 in the rotation knob 400. To articulate the end effector 12 relative to the longitudinal axis A-A, the surgeon first moves the right and left articulation handles 458, 460 axially in the distal direction “DD” to disengage the locking detents 454 from the locking ribs 410 in the hub portion 402 of the rotation knob 400. Thereafter, the surgeon may pivot the articulation ball 440 by moving the articulation handles 458, 460 in the desired directions to apply articulation motions to the articulation members 420, 430. For example, the end effector 12 may be pivoted to the right by moving the right articulation handle 458 in the proximal direction “PD” and the left articulation handle 460 in the distal direction “DD” to apply a pulling motion (articulation motion) to the right articulation member 420 and a pushing motion to the left articulation member 430. Similarly, the end effector 12 may be pivoted to the left by moving the left articulation handle 460 in the proximal direction “PD” and the right articulation handle 458 in the distal direction “DD” to apply a pulling motion (articulation motion) to the left articulation member 430 and a pushing motion to the right articulation member 420. The various ranges of motions of the right and left articulation handles 458, 460 are illustrated in broken lines in FIG. 38. In this way, the end effector 12 can be optimally positioned in a variety of angular positions, e.g., by angling clockwise or counterclockwise, without requiring rotation or other movement of the elongated shaft assembly 40. FIG. 35 shows the angle α which in various embodiments can be from 0° to 45°.

Various embodiments of the surgical instrument 310 include a knife bar 472 that is movably supported within the hollow proximal spine segment 330 and through a knife support slot 333 that tapers from a narrow proximal portion 335 to a wide distal portion 337 to enable the knife bar 472 to flex therearound to accommodate the articulation of the end effector 12 about the longitudinal axis A-A. See FIG. 37. In various embodiments, the knife bar 472 may be fabricated from, for example, 300 or 400 Series stainless steel and have a tissue cutting edge 476 formed on the distal end thereof. As can be further seen in FIG. 37, the knife bar 472 slidably passes through a knife slot 473 in the distal pivot base 326. A proximal end 478 of the knife bar 472 is attached to a knife rod 480 that extends through the proximal spine segment 330 to drivingly engage the firing transmission 190 as was described above. See FIG. 31. The retention pin 406 extends into a longitudinal slot 392 (FIG. 38) in the proximal firing tube segment 390 and through a hole 339 in the proximal spine segment 330 (FIG. 39) and into a longitudinal slot 482 in the knife rod 480 to enable the proximal firing tube segment 390 and the knife rod 480 to move axially relative to the proximal spine segment 330 and handle assembly 100. Thus, the surgeon may selectively operate the knife bar 472 to cut tissue by operating the knife advancement trigger 200 in the manner described above.

Various articulation arrangements are disclosed in U.S. patent application Ser. No. 12/775,809, entitled LAPAROSCOPIC DEVICES WITH ARTICULATING END EFFECTORS, filed May 7, 2010, now U.S. Patent Application Publication No. 2011/0275901, and U.S. patent application Ser. No. 12/775,699, entitled BENDABLE SHAFT FOR HANDLE POSITIONING, filed May 7, 2010, now U.S. Patent Application Publication No. 2011/0276083, the disclosures of each being herein incorporated by reference in their respective entireties. FIGS. 41 and 42 illustrate an alternative articulated shaft assembly 490 that is substantially identical to the articulated shaft assembly 340 and is operated in substantially the same way except for the intermediate firing tube segment 492 which replaces the firing tube link 380 employed in the articulated shaft assembly 340. As can be seen in FIGS. 41 and 42, the intermediate firing tube segment 492 extends from the distal firing tube segment 370 to the proximal firing tube segment 390. In various embodiments, the intermediate firing tube segment 492 may be fabricated from Nylon, Isoplast®, or other flexible plastic. In various embodiments, the intermediate firing tube segment 492 has two longitudinally extending compression spine portions 494 from which a plurality of spaced rib segments 496 that are separated by spaces 498 extend to form a substantially hollow tube segment through which the other components of the spine assembly and knife bar may operably pass. The spine portions 494 are configured to transmit the compression motions from the proximal firing tube segment 390 to the distal firing tube segment 370 which are of sufficient magnitude to actuate the anvil 20 to a fully fired position while enabling the end effector 12 to be selectively articulated relative to the longitudinal axis A-A. The intermediate firing tube segment 492 has a distal end portion 491 that is attached to the distal firing tube segment by, for example, pins, slotted bosses, snap features, etc. as well as proximal portion 493 that is attached to the proximal firing tube segment 390 by the same or similar means. In this embodiment, the end effector 12 can be optimally positioned in a variety of angular positions, e.g., by angling clockwise or counterclockwise, without requiring rotation or other movement of the elongated shaft assembly 490. FIG. 42 shows the angle α which in various embodiments can be from 0° to 45°.

FIGS. 43-47 illustrate another surgical instrument embodiment of the present invention. The surgical instrument 510 of this embodiment is substantially similar to the surgical instrument embodiment 310 described above, except for the various differences discussed below. While the surgical instrument 510 will be described herein for use in connection with an end effector 12 of the type described above, those of ordinary skill in the art will appreciate that the surgical instrument may also be employed in connection with a second firing adapter 150 to actuate an end effector 12′ or it may be used in connection with other end effector arrangements. Various embodiments of the surgical instrument 510 include an articulated shaft assembly 512 to facilitate selective positioning of the end effector 12 relative to the longitudinal axis A-A. As can be seen in FIGS. 43 and 44, the articulated shaft assembly 512 includes a distal spine member 520 that has a pair of trunion cradles 522 therein for receiving the trunions 17 therein. The distal spine member 520 has a proximal end 521 that is pivotally coupled to a distal end 531 of a proximal spine segment 530. In particular, the proximal end 521 of the distal spine segment 520 has a pair of spaced distal spine tines 523 that support an articulation pin 524 that extends through the distal end 531 of the proximal spine segment 530 to define an articulation axis AA-AA that is substantially transverse to longitudinal axis A-A. See FIG. 46.

In various embodiments of the present invention, the end effector 12 is articulatable to a variety of different orientations about the longitudinal axis A-A. For example, angle α′ in FIG. 47 can range from 180° to 90°. The end effector 12 is articulated by means of at least one articulation member 550 that is coupled to an articulation link 540. Articulation link 540 is pivotally coupled to the distal end 521 of the distal spine segment 520 by a distal pin 542. See FIG. 43. The articulation link 540 is pivotally coupled to the distal end 552 of the articulation rod 550 by an articulation rod pin 554 as shown in FIG. 46. As can be seen in FIG. 43, the articulation member 550 extends through the articulated shaft assembly 512 and has a proximal end 556 that extends into a rotation knob 560 that is rotatably coupled to the handle assembly 100. The proximal end 556 of the articulation member 550 is coupled to an articulation control member or button 558 that is slidably coupled to the rotation knob 560 for selective axial travel relative thereto. Thus, axially sliding the articulation button 558 in the distal direction “DD” will cause the end effector 12 to pivot about the longitudinal axis A-A in the manner illustrated in FIG. 47. To return the end effector to a starting unarticulated position wherein the end effector is coaxially aligned on the longitudinal axis A-A, the surgeon simply slides the actuator button 558 in the proximal direction “PD” on the rotation knob 560.

As with some of the embodiments described above, the rotation knob 560 is non-rotatably coupled to a mounting bushing 570 that is rotatably affixed to the handle assembly 100. See FIGS. 43 and 47. The mounting bushing 570 has a proximal flange 572 and a distal flange 574 that define a rotational groove 575 therebetween to rotatably receive a nose portion 101 of the handle assembly 100 therebetween. Such arrangement enables the mounting bushing 570 to rotate about longitudinal axis A-A relative to the handle assembly 100. The proximal spine segment 530 is non-rotatably pinned or otherwise attached (welded, adhesive, etc.) to the mounting bushing 570 such that rotation of the rotation knob 560 about longitudinal axis A-A causes the end effector 12 to rotate about longitudinal axis A-A. It will be understood that such arrangement may facilitate rotation of the end effector 12 in a 360° path about the longitudinal axis A-A.

This embodiment also has a distal firing tube segment 580 that is coupled to the first firing adapter 140 and axially movable on the distal spine segment 520. In particular, the retainer button 144 on the first firing adapter 140 is received within a retainer hole 581 in the distal firing tube segment 580 in the manner described above. The distal firing tube segment 580 is actuated by at least one firing member that is attached thereto. In a preferred embodiment, the distal firing tube segment 580 is actuated by a pair of firing bands 582, 584 attached thereto. The firing bands 582, 584 are attached to a band mount 585 coupled to a proximal firing tube segment 590 that is attached to the firing yoke 114 in the above-described manner. Also journaled on the proximal spine segment 530 and coupled to the rotation knob 560 for rotation therewith is a cover tube 592. The proximal firing tube 590 and the band mount 585 are axially movable relative to the cover tube 592. The firing bands 582, 584 are slidably received within lateral band channels 526 in the distal spine member 520 as shown in FIG. 44C. In various embodiments, the firing bands 582, 584 each comprise a thin flexible member that may be fabricated from, for example, stainless steel and are each capable of pushing on the distal firing tube segment 580 to actuate or close the anvil 20 in the above-described manner to form the staples 32 in the implantable staple cartridge 30. Actuation of the firing cables 582, 584 is accomplished by pulling the firing trigger 130 in the above-described manners. Returning the firing trigger 130 to the starting position will pull on the firing cables 582, 584 and cause the first firing adapter 140 to either pull the anvil 20 to an open position or to move to a position wherein a spring (not shown) biases the anvil 20 to the open position.

The surgical instrument 510 may further include a knife 534 that is movably supported within a knife support slot 528 in the distal spine segment 520. See FIG. 44B. In various embodiments, the knife bar 534 may be fabricated from, for example, 300 or 400 stainless steel, etc. and have a tissue cutting edge 535 formed on the distal end thereof. The knife bar 534 is attached to a knife band 536 that may be fabricated from 300 or 400 series stainless steel. The knife band may, for example, comprise 0.007 to 0.012 inch thick stainless steel band material that is more hardened than the rod. The knife cable 536 extends through the distal spine member 520 and the proximal spine segment 530 and is attached to a knife rod 480 that drivingly engages the firing transmission 190 as was described above. Thus, the surgeon may selectively operate the knife bar 534 to cut tissue by operating the knife advancement trigger 200 in the manner described above. Various embodiments may also employ a bellows-like cover member 594 to prevent dirt, tissue, debris, etc. from fouling the articulation joint. See FIG. 48.

FIGS. 49-53 illustrate another surgical instrument embodiment of the present invention. The surgical instrument 610 of this embodiment is substantially similar to the surgical instrument embodiment 10 described above, except for the differences explained below. The surgical instrument 610 is configured to actuate an end effector 612 that has two movable jaws 613, 615. In various embodiments, the end effector 612 is coupled to an elongated shaft assembly 655 that protrudes from a handle assembly 100. See FIG. 49. The elongated shaft assembly 655 includes an elongated spine assembly 658 and an elongated closure tube assembly 680 that is axially movable on the spine assembly 658 in the proximal and distal directions. As shown, the elongated shaft assembly 655 extends distally from the handle assembly 100 in a generally straight line along a longitudinal axis A-A. In various embodiments, the elongated shaft assembly 655 may be approximately 9 to 16 inches (approximately 228.8 mm to 406.4 mm) long. However, the elongated shaft assembly 655 may be provided in other lengths.

Referring to FIGS. 50 and 51, in various embodiments, the lower jaw 613 of the end effector 612 comprises an elongated channel 614 and the upper jaw 615 comprises an anvil 620. The elongated channel 614 has a pair of spaced side walls 616 that each terminate in an upwardly protruding closure end or tip 618. The elongated channel 614 may be fabricated from, for example 17-4 or 400 series stainless steel and be sized to operably support a staple cartridge 630 or other form of staple cartridge therein. The anvil 620 may be fabricated from 416, 17-4, 17-7 stainless steel, etc. In at least one embodiment, for example, end effector 612 (when in a closed position) and the elongated shaft assembly 655 each have a maximum outer diameter that would permit the device to be operably passed through an opening that has a diameter of at least approximately 8-12 mm (approximately 0.31-0.47 inches). However, the end effector 612 and elongated shaft assembly 655 may have other diameters and shapes. The end effector 612 further includes a distal spine segment 660 that is adapted to be removably coupled to a distal end of a proximal spine segment 670 as will be further explained below.

The anvil 620 has a staple forming portion 622 that has a plurality of staple forming pockets formed therein. In addition, the anvil 620 has a bifurcated closure portion 624 that includes at least one and preferably a pair of downwardly extending closure tips 625. As can be seen in FIGS. 50-53, in at least one embodiment, the closure tips 625 and the corresponding closure ends or tips 618 of the elongated channel 614 are pivotally pinned to spine lugs 663 of a bifurcated distal end 662 of a distal spine segment 660 (FIG. 55) of a spine assembly 658 by a pivot pin 626 such that, when viewed from the side, the closure tips 625 and closure tips 618 form a movable “scissors-like” closure structure generally designated as 628. In other embodiments, the anvil 620 may be movably coupled to the elongated channel 614.

Various embodiments of the end effector 612 also include an axially movable knife assembly 640 that includes a knife plate 642 that has a pair of spaced knife bars 644 protruding distally therefrom that are configured to slide axially between the spine lugs 663 of the distal spine segment 660. See FIG. 55. A knife member 646 is attached to, or otherwise formed on, the distal ends of the knife bars 644. In various embodiments, the knife bars 644 and the knife member 646 may be fabricated from, for example, 300 or 400 Series stainless steel. A tissue cutting edge 648 is formed on a distal end of the knife member 646. A lower portion 649 of the knife member 646 is configured to engage a staple driving sled 650 that is movably supported within the elongated shaft 614. The staple driving sled 650 may be retained in a slot or slot arrangements (not shown) in the elongated channel 614 to facilitate axial movement of the staple driving sled 650 from a starting position (FIGS. 50-52) to an end position (FIG. 53) while remaining connected to the elongated channel 614. The staple driving sled 650 has a staple driving surface or surfaces 652 thereon that are oriented to drivingly engage the staples 632 in the staple cartridge 630 and drive the staples 632 upward toward the staple forming portion 622 of the anvil 620 as the knife member 646 is distally advanced through the end effector 612.

Also in various embodiments, a distal spine nut 668 is rotatably coupled to the proximal end 664 of the distal spine segment 660 for rotational travel relative thereto about the longitudinal axis A-A. The distal spine nut 668 has a pair of inwardly extending trunions 669 that are sized to be received in corresponding trunion slots 674 in a distal end 672 of a proximal spine segment 670 that protrudes from the handle assembly 100 to enable the distal spine segment 660 to rotate relative to the proximal spine segment 670. As can be seen in FIG. 49, the proximal spine segment 670 is pinned to the rotation knob 70 (by pin 66) that is rotatably mounted to the handle assembly 100 in the above-described manner to facilitate rotation of the end effector 612 about the longitudinal axis A-A in a 360° path.

As can also be seen in FIG. 49, a flange 676 is formed on a proximal end 671 of the proximal spine segment 670. The flange 676 is configured to be rotatably supported within a groove 106 formed by mating ribs 108 that protrude inwardly from each of the case members 102, 104. Such arrangement facilitates the attachment of the proximal spine segment 670 to the handle assembly 100 while enabling the proximal spine segment 670 to be rotated relative to the handle assembly 100 about the longitudinal axis A-A in a 360° path. The proximal closure tube segment 682 may be fabricated from a polymer or other suitable material and have a proximal end 683 that is attached to a firing yoke 114 that is constructed and movably mounted within the handle assembly 100 in the various manners described above. In various embodiments for example, the firing yoke 114 may be over-molded to the proximal end 683 of the proximal closure tube segment 682. However, other fastener arrangements may be employed. As described above, the firing yoke 114 may be rotatably supported within a support collar 120 that is configured to move axially within the handle assembly 100. As can be seen in FIG. 49, a longitudinal slot 681 is provided through the proximal closure tube segment 682 to enable the spine pin 66 to extend therethrough into the proximal spine segment 670 while facilitating the axial travel of the proximal closure tube segment 682 on the distal spine segment 670.

As can be seen in FIG. 49, the firing trigger 130 has an upper portion 134 that is pivotally (pinned) to firing links 636, 638 that are pivotally (pinned) to the support collar 120. Thus, movement of the firing trigger 130 toward the pistol grip portion 107 of the handle assembly 100 will cause the firing yoke 114 and the proximal closure tube segment 682 to move in the proximal direction “PD” (shown in broken lines in FIG. 49). Movement of the clamp and firing trigger 130 away from the pistol grip portion 107 of the handle assembly 100 will cause the firing yoke 114 and firing tube 110 to move in the proximal direction “DD” on the proximal spine segment 670.

As can be seen in FIGS. 50-53, the proximal closure tube segment 682 has a distal end 684 that is configured to be attached to a proximal end 692 of a distal closure tube segment 690. In the illustrated embodiment, the distal closure tube segment 690 is configured to be threadably attached to the distal end 684 of the proximal closure tube segment 682. The distal end 694 of the distal closure tube segment 690 has a tapered drive member 696 therein that is configured to interface with the scissors-like closure structure 628 such that when the distal closure tube segment 690 is in the position illustrated in FIG. 51, an end effector spring or springs 617 positioned between the elongated channel 614 and the anvil 620 serves to bias the anvil 620 to the open position illustrated in that Figure. However, when the distal closure tube segment 690 is pulled in the proximal direction “PD”, the tapered drive member 696 contacts the scissors-like closure structure 628 to pivot the jaws 613 (elongated channel 614) and 615 (anvil 620) towards each other. See FIGS. 52 and 53.

The surgical instrument 610 may further include a knife advancement system 639 that includes knife rod 700 that extends through the proximal spine segment 670 and has a proximal end portion 702 that drivingly interfaces with a firing transmission 190 that is operably attached to a knife advance trigger 200 in the manner described above. Thus, the surgeon may advance the knife rod 700 distally by pulling the knife advancement trigger 200 as was described above. As can be seen in FIGS. 52 and 53, the knife rod 700 has a bifurcated distal end 704 that includes an upper knife rod segment 706 and a lower knife rod segment 708 that are configured to engage the knife plate 642. As can be seen in FIGS. 51-54, the upper knife rod segment 706 is configured to slide through an upper slot 773 in the spine nut 668 and the lower knife rod segment 708 is configured to slide through a lower slot 775 in the spine nut 668.

To use the surgical instrument 610, the end effector 612 is attached to the distal end 672 of the proximal spine segment 670 by inserting the trunions 669 on the spine nut 668 into their corresponding trunion cradles 674 in the proximal spine segment 670. See FIG. 50. Thereafter, the surgeon or clinician may rotate the end effector 612 relative to the elongated shaft assembly 655 to thread the distal closure tube segment 690 onto the proximal closure tube segment 682 to form the closure tube assembly 680. The end effector 612 may have the staple cartridge 630 therein or the clinician may install the staple cartridge into the elongated channel 614 at this or a later time. Once the end effector 612 has been attached to the elongated shaft assembly 655 of the surgical instrument 610, the surgeon may insert the end effector 612 and elongated shaft assembly 655 through an access passage extending into the patient (e.g., through a trocar or endoscope, etc. or through an incision—in the case of open surgery) to grasp the target tissue between the end effector jaws 613, 615. As with various embodiments described above, the jaws 613, 615 are closed by manipulating the firing trigger 130 relative to the pistol grip 107 of the handle assembly 100. Once the target tissue has been grasped between the end effector jaws 613, 615, the surgeon may “fire” or form the staples 632 into the target tissue by compressing the anvil 620 into the staple cartridge 630 in the manner described above. If the procedure does not require the target tissue to be cut, the surgeon may then release the firing trigger 130 to permit the anvil 620 to move to the open position (under biasing motion from spring 617) and thereby release the implantable staple cartridge 630 from the end effector 612. The surgeon may then re-close the end effector jaws 613, 615 to permit the end effector 612 to be withdrawn through an access passage or working channel. If, however, the surgeon desires to cut the target tissue between the lines of staples 632, the surgeon may fire the knife assembly 640 by operating the knife advancement trigger 200 in the manner described above to drive the knife member 648 distally through the target tissue. As the knife member 648 moves distally through the end effector 612, it contacts the staple driving sled 650 which serves to further drive the staples 632 into forming contact with the staple forming surface 622 of the anvil 620 to further form the staples 632. See FIG. 53. Thereafter, the surgeon may open the end effector 612 to release the cut/staple target tissue and implantable staple cartridge 630 therefrom.

Thus, the unique and novel closure tube arrangement which closes the jaws of the end effector by moving the closure tube distally enables smaller closure structures to be employed while still maintaining the ability to generate large closure forces required to form staples. In addition, this embodiment of the present invention provides the surgeon with the flexibility to staple tissue with out cutting it in applications not requiring the tissue to be cut.

FIGS. 56-60 illustrate an alternative surgical instrument embodiment 810 that is substantially identical to the surgical instrument 610 described above, except for the differences discussed below. The surgical instrument 810, for example, includes a flexible spine assembly 820 that has a proximal end with a flange 822 thereon that is rotatably received within a groove 106 formed by mating ribs 108 that protrude inwardly from each of the case members 102, 104 forming the handle assembly 100. See FIGS. 57 and 58. Such mounting arrangement facilitates rotational travel of the flexible spine assembly 820 relative to the handle assembly 100. In various embodiments, the flexible spine assembly 820 may be fabricated from, for example, Nylon, Acrylonitrile butadiene styrene (ABS), polycarbonate, liquid crystal polymer, stainless steel, titanium, etc. and may be configured for use with an end effector 612 of the type described above.

The surgical instrument 810 further includes an elongated shaft assembly generally represented by 830. In various embodiments, for example, the elongated shaft assembly 830 includes a reconfigurable shaft segment 840 and a proximal shaft segment 844. As can be seen in FIG. 56, for example, the reconfigurable shaft segment 840 may have a distal mounting collar 842 that is non-movably attached to a portion of the flexible spine assembly 820 by, for example, adhesive, welding, fasteners, etc. The reconfigurable shaft segment 840 is selectively reconfigurable between a linear configuration wherein all portions of the reconfigurable segment 840 are substantially coaxially aligned with each other (i.e., they form a substantially straight hollow tubular structure) and configurations wherein at least one of the portions is not coaxially or linearly aligned with another portion of the reconfigurable segment 840. In the embodiment depicted in FIG. 56, for example, the reconfigurable shaft segment 840 may be fabricated from Nylon, Acrylonitrile butadiene styrene (ABS), polycarbonate, etc. and have a plurality of ribs 846 that facilitate the reconfiguration of the segment 840 from a linear or coaxial alignment orientation to non-linear or non-coaxial orientations (e.g., serpentine, curved, etc.) and remain in such orientations until the user reconfigures the shaft segment 840 by hand or through the use of other surgical instruments such as grasping devices and the like. Thus, the reconfigurable shaft segment 840 is “passively articulatable” meaning that the device is not equipped with articulation means for actively controlling the articulation of the segment 840.

In various embodiments, the proximal shaft segment 844 is coupled to the reconfigurable shaft segment 840 by, for example, interlocking features or pins and serves to facilitate rotational attachment of the reconfigurable shaft segment 840 to the handle assembly 100. In at least one embodiment, for example, the proximal shaft segment 844 is coupled to the mounting bushing 60 that is rotatably affixed to the handle assembly 100 as described hereinabove. See FIGS. 57 and 59.

Also in various embodiments, a closure tube segment 832 is movably mounted on a portion of the flexible spine assembly 820 for selective movement thereon. See FIGS. 56 and 60. As can be seen in FIG. 60, in at least one embodiment, the closure tube segment 832 and the spine assembly 820 are formed with opposing flanged portions 833, 821 respectively, such that the closure tube segment 832 is prevented from sliding off of the spine assembly 820 while remaining movably mounted thereon. In various embodiments, a flexible closure member 848 is coupled to, or comprises a portion of, the firing yoke 114. See FIGS. 57 and 59. The flexible closure member 848 may be fabricated from, for example, stainless steel, etc. and have a distal end portion 849 that extends through an elongated slot 834 in the spine assembly 820 to be coupled to the closure tube segment 832. Such arrangement facilitates movement of the closure tube segment 832 in the distal direction “DD” and proximal direction “PD” on the spine assembly 820 by actuating the firing trigger 130 in the manners described above.

As can be seen in FIG. 56, the surgical instrument 810 may be employed with an end effector 612 which was described in detail above. In particular, the end effector 612 may be removably coupled to the flexible spine assembly 820 by inserting the trunions 669 on the spine nut 668 into corresponding trunion slots 825 in a distal end 825 of the spine assembly 820. See FIG. 60. A distal end 835 of the closure tube segment 832 is configured to be threadably attached to the proximal end 692 of the distal closure tube segment 690 in the above-described manner.

In at least one embodiment, the surgical instrument 810 further includes a knife advancement system 639 that includes knife rod 700 that extends through the spine assembly 820 and has a proximal end portion 702 that drivingly interfaces with a firing transmission 190 that is operably attached to a knife advance trigger 200 in the manner described above. Thus, the surgeon may advance the knife rod 700 distally by pulling the knife advancement trigger 200 as was described above. The knife rod 700 has a bifurcated distal end 704 that includes an upper knife rod segment 706 and a lower knife rod segment 708 that are configured to engage the knife plate 642 in the end effector 612. See FIG. 60.

To use the surgical instrument 810, the end effector 612 is attached to the distal end 823 of the spine assembly 820 by inserting the trunions 669 on the spine nut 668 into their corresponding trunion cradles 825. Thereafter, the surgeon or clinician may rotate the end effector 612 to thread the distal closure tube segment 690 onto the closure tube segment 832. The end effector 612 may have the staple cartridge 630 therein or the clinician may install the staple cartridge into the elongated channel 614 at this time. Once the end effector 612 has been attached to the elongated closure tube assembly 830 of the surgical instrument 810, the surgeon may configure the reconfigurable shaft segment 840 such that the elongated shaft assembly portions are coaxially aligned for insertion through an opening or working channel that extends into the patient (e.g., through a trocar or endoscope, etc. or through an incision—in the case of open surgery). Thereafter, the surgeon may reconfigure the reconfigurable shaft segment 840 such that portions thereof are not coaxially aligned with each other to orient the end effector 612 attached thereto in a desired position relative to the target tissue. As with various embodiments described above the jaws 613, 615 are closed by manipulating the firing trigger 130 relative to the pistol grip 107 of the handle assembly 100. Once the target tissue has been grasped between the end effector jaws 613, 615, the surgeon may “fire” or form the staples 632 into the target tissue by compressing the anvil 620 into the staple cartridge 630 in the manner described above. If the procedure does not require the target tissue to be cut, the surgeon may then release the firing trigger 130 to permit the anvil 620 to move to the open position (under biasing motion from spring 617) and thereby release the implantable staple cartridge 630 from the end effector 612. The surgeon may then re-close the end effector jaws 613, 615 and reconfigure the reconfigurable shaft segment 840 to permit the end effector 612 to be withdrawn through an access passage or working channel. If, however, the surgeon desires to cut the target tissue between the lines of staples 632, the surgeon may fire the knife assembly 640 by operating the knife advancement trigger 200 in the manner described above to drive the knife member 648 distally through the target tissue. As the knife member 648 moves distally through the end effector 612, it contacts the staple driving sled 650 which serves to further drive the staples 632 into forming contact with the staple forming surface 622 of the anvil 620 to further form the staples 632. Thereafter, the surgeon may open the end effector 612 to release the cut/staple target tissue and implantable staple cartridge 630 therefrom.

FIGS. 61 and 62 illustrate another surgical instrument embodiment 810′ that is substantially identical to the surgical instrument 810 embodiment described above, except for the reconfigurable shaft segment 850 which comprises a portion of an elongated shaft assembly 830′ that is operably coupled to handle assembly 100 for operating an end effector 612. In various embodiments, the reconfigurable shaft segment 850 comprises a plurality of movably interconnected tubular links 852. Each tubular link 852 may be fabricated from, for example, Nylon, Acrylonitrile butadiene styrene (ABS), polycarbonate with or without glass or carbon fill, etc. and have a tubular body portion 854. The tubular body portion 854 may have a sphere-like or ball-like coupler portion 856 formed thereon that has a spine-receiving passage 858 therethrough. In addition, the tubular spine-receiving passage 858 extends into a hollow socket 860 formed in the tubular body portion 854 that is sized to movably receive the ball-like coupler portion 856 of an adjacent tubular link 852. The ball-like coupler portions 856 are sized relative to the sockets 860 to permit the ball-like coupler portion 856 to be snapped therein and retained in a desired configuration wherein the shaft segment is in a substantially straight line to configurations wherein the shaft 850 may have a curved (FIG. 62) or serpentine-like configuration (FIG. 61).

While the ball-like coupler portions 856 and sockets 860 may be sized relative to each other to create a small amount of frictional force therebetween that can retain the segment 850 in a desired orientation until an external force is applied thereto, the embodiment depicted in FIGS. 60 and 61, employs a locking system 862 to releasably retain or immovably lock the tubular links 852 together in a desired configuration. As can be seen in those Figures, the locking means 862 comprises at least one, and preferably a plurality of, flexible latch nubs or members 864 formed on the perimeter of the tubular link 852 adjacent one end 853 thereof. In a preferred embodiment, four latch nubs 864 are employed. Other embodiments could have 1, 2, 3 or more than four latch nubs 864. Each tubular link 852 further comprises a locking member 866 that corresponds to each latch nub 864 adjacent the other end 865 of the link 852. Each locking member 866 has a latch-receiving notch 868 therein configured to releasably receive a portion of the corresponding latch nub 864 formed on an adjacent tubular link 852 therein.

To use the surgical instrument 810′, the end effector 612 is attached to the distal end 823 of the spine assembly 820 in the manner described above. The distal closure tube segment 690 of the end effector 612 is threaded onto the closure tube segment 832. Once the end effector 612 has been attached to the elongated closure tube assembly 830 of the surgical instrument 810′, the surgeon may configure the reconfigurable shaft segment 850 such that the elongated shaft assembly portions are coaxially aligned for insertion through an opening or working channel that extends into the patient (e.g., through a trocar or endoscope, etc. or through an incision—in the case of open surgery). Thereafter, the surgeon may employ, for example, a grasping instrument 869 to configure the movable links 852 of the reconfigurable shaft segment 850 to a desired orientation and then press the appropriate locking nubs 864 on each link 852 into their corresponding latch receiving notch 868 to lock the links 852 in the desired orientation. See FIG. 62. As with various embodiments described above, the jaws 613, 615 are closed by manipulating the firing trigger 130 relative to the pistol grip 107 of the handle assembly 100. Once the target tissue has been grasped between the end effector jaws 613, 615, the surgeon may “fire” or form the staples 632 into the target tissue by compressing the anvil 620 into the staple cartridge 630 in the manner described above. If the procedure does not require the target tissue to be cut, the surgeon may then release the firing trigger 130 to permit the anvil 620 to move to the open position (under biasing motion from spring 617) and thereby release the implantable staple cartridge 630 from the end effector 612. The surgeon may then re-close the end effector jaws 613, 615 and use the grasping instrument 869 to remove the locking nubs 864 from their corresponding latch receiving notches 868 to permit the links 852 to be aligned in such a manner to permit the device to be withdrawn through an access passage or working channel. If, however, the surgeon desires to cut the target tissue between the lines of staples 632, the surgeon may fire the knife assembly 640 by operating the knife advancement trigger 200 in the manner described above to drive the knife member 648 distally through the target tissue. As the knife member 648 moves distally through the end effector 612, it contacts the staple driving sled 650 which serves to further drive the staples 632 into forming contact with the staple forming surface 622 of the anvil 620 to further form the staples 632. Thereafter, the surgeon may open the end effector 612 to release the cut/stapled target tissue and implantable staple cartridge 630 therefrom.

FIGS. 63-68 illustrate another surgical instrument embodiment 810″ that is substantially identical to the surgical instrument embodiments 810, 810′ described above, except for the reconfigurable shaft segment 870 and related locking system 882 of the elongated shaft assembly. In various embodiments, the reconfigurable shaft segment 870 comprises a plurality of movably interconnected tubular links 872 and is coupled to a proximal shaft segment 871 that is coupled to the mounting bushing 60 rotatably supported within the handle assembly 100 as discussed in detail above. Each tubular link 872 may be fabricated from, for example, Nylon, Acrylonitrile butadiene styrene (ABS), polycarbonate, etc. and have a tubular body portion 874. See FIG. 67. The tubular body portion 874 may have a sphere-like or ball-like coupler portion 876 formed thereon that has a spine-receiving passage 878 extending therethrough. In addition, the tubular spine-receiving passage 878 extends into a hollow socket 880 formed in the tubular body portion 854 that is sized to movably receive the ball-like coupler portion 876 of an adjacent tubular link 872. The ball-like coupler portions 876 are sized relative to the sockets 880 to permit the ball-like coupler portion 876 to be snapped therein and retained in a desired configuration wherein the reconfigurable shaft segment 870 is in a substantially straight line (FIG. 67) to configurations wherein the shaft 870 may have a curved (FIG. 68) or serpentine-like configuration.

While the ball-like coupler portions 876 and sockets 880 may be, in at least one embodiment, sized relative to each other to create a small amount of frictional force therebetween that can retain tubular links 872 of the reconfigurable shaft segment 870 in desired orientations until an external force is applied thereto, the embodiment depicted in FIGS. 63-68, employs a locking system 882 for releasably retaining or immovably locking the tubular links 872 together in a desired configuration. As can be seen in FIGS. 67 and 68, the locking means 882 comprises at least one, and preferably two, selectively expandable locking bladders 884 that extend through the tubular links 872 in diametrically opposed positions. In various embodiments, the locking bladders 884 may be fabricated from, for example, Nylon film, etc. and be adapted to receive pressurized fluid from a source of pressurized fluid 886. In the embodiment depicted in FIG. 64, the source of pressurized fluid 886 comprises fluid pump arrangement 888 that is adapted to supply air under pressure into the locking bladders 884. In particular, in at least one embodiment, the fluid pump arrangement 888 comprises a cylinder 889 that has a piston 890 therein. The piston 890 has an O-ring or other seal arrangement 891 around its perimeter and is attached to a threaded pump handle 892 that threadably engages a portion of the handle assembly 100. Thus, by screwing the pump handle 892 into the handle assembly 100, air in the cylinder 890 is pumped under pressure through a supply conduit 893 that extends from the cylinder 890 to a manifold assembly 894 that is received on the spine assembly 820. The air pressure may be relieved in the locking bladders 884 by screwing the pump handle 894 in an opposite direction.

As can be seen in FIG. 65, the manifold assembly 894 comprises an annular manifold area 895 that is sealed on each side by O-rings or other seals 896. The annular manifold area 895 communicates with a supply line 897 that extends through the proximal shaft segment 871 and which is coupled for discharge into the locking bladders 884. Such arrangement serves to supply pressurized air into the locking bladders 884 while facilitating the rotational travel of the spine assembly 820 about the longitudinal axis A-A relative to the handle assembly 100. As used herein, the term pressurized fluid may comprise, for example, air, saline or preferably glycerine. In alternative embodiments, the tubular members may be filled with a very low durometer rubber or elastomer. When a pressure is applied to the rubber material, it will deform filing the voids and locking the shaft in much the same way as the fluid embodiment does.

To use the surgical instrument 810″, the end effector 612 is attached to the distal end 823 of the spine assembly 820′ in the manner described above. The distal closure tube segment 690 of the end effector 612 is threaded onto the closure tube segment 832. Once the end effector 612 has been attached to the elongated shaft assembly 830″ of the surgical instrument 810″, the surgeon may configure the reconfigurable shaft segment 870 such that the elongated shaft assembly portions 830″ are coaxially aligned for insertion through an opening or working channel that extends into the patient (e.g., through a trocar or endoscope, etc. or through an incision—in the case of open surgery). Thereafter, the surgeon may employ, for example, a grasping instrument to configure the movable links 872 of the reconfigurable shaft segment 870 to a desired orientation. Once the reconfigurable shaft segment 870 has been oriented in a desired orientation, the surgeon may then screw in the pump handle 892 into the handle housing 100 to pressurize the locking bladders 884 to lock the movable links 872 in position as shown in FIG. 68. As with various embodiments described above, the jaws 613, 615 are closed by manipulating the firing trigger 130 relative to the pistol grip 107 of the handle assembly 100. Once the target tissue has been grasped between the end effector jaws 613, 615, the surgeon may “fire” or form the staples 632 into the target tissue by compressing the anvil 620 into the staple cartridge 630 in the manner described above. If the procedure does not require the target tissue to be cut, the surgeon may then release the firing trigger 130 to permit the anvil 620 to move to the open position (under biasing motion from spring 617) and thereby release the implantable staple cartridge 630 from the end effector 612. The surgeon may then re-close the end effector jaws 613, 615 and release the pressure in the locking bladders 884 by screwing the pump handle 892 in an opposite direction. A grasping instrument may be employed to manipulate the movable links 872 to a substantially coaxially aligned orientation (FIG. 67) or other orientation required to enable the device to be withdrawn from the patient. If, however, the surgeon desires to cut the target tissue between the lines of staples 632, the surgeon may fire the knife assembly 640 by operating the knife advancement trigger 200 in the manner described above to drive the knife member 648 distally through the target tissue. As the knife member 648 moves distally through the end effector 612, it contacts the staple driving sled 650 which serves to further drive the staples 632 into forming contact with the staple forming surface 622 of the anvil 620 to further form the staples 632. Thereafter, the surgeon may open the end effector 612 to release the cut/stapled target tissue and implantable staple cartridge 630 therefrom.

The various embodiments disclosed herein that include a reconfigurable shaft segment represent a vast improvement over traditional articulatable surgical instrument arrangements that employ lockable articulation joints. Such surgical instruments are typically limited to 1 or 2 degrees of freedom for placement of the end effector at the transection site. The various embodiments of the present invention allow for a wider range of possible end effector positions and therefore provide the surgeon with much more flexibility when using the device through a single access port.

The unique and novel features of the various surgical staple cartridges and the surgical instruments of the present invention enable the staples in those cartridges to be arranged in one or more linear or non-linear lines. A plurality of such staple lines may be provided on each side of an elongated slot that is centrally disposed within the staple cartridge for receiving the tissue cutting member therethrough. In one arrangement, for example, the staples in one line may be substantially parallel with the staples in adjacent line(s) of staples, but offset therefrom. In still other embodiments, one or more lines of staples may be non-linear in nature. That is, the base of at least one staple in a line of staples may extend along an axis that is substantially transverse to the bases of other staples in the same staple line. For example, as will be discussed in further detail below, in alternative embodiments, the lines of staples on each side of the elongated slot may have a zigzag appearance. Such non-linear staple arrangements may be made possible due to the fact that the staples are not driven upwardly into the anvil. Instead in these various embodiments, the anvil is brought into forming contact with the tips of the non-moving staples. Such non-linear staple arrangements may attain better tissue fastening results with less staples than various linear staple arrangements employed in prior staple cartridges wherein the staples are actually driven upwardly into forming contact with the anvil.

FIG. 69 illustrates use of a surgical staple cartridge embodiment 900 in an end effector embodiment 612′ of the present invention. The end effector 612′ may be used in connection with the surgical instrument 610 in the various manners described above. The end effector 612′ may be identical to end effector 612 as described above except for the differences described below. As can be seen in FIGS. 69 and 70, an embodiment of the surgical staple cartridge 900 has a cartridge body 902 that has a centrally disposed elongated slot 904 extending through a proximal end 903 to an area adjacent a distal end 605. The elongated slot 904 is configured to permit knife body 646 of the surgical instrument 610 to axially move therethrough during a tissue cutting operation in the manner described above. In at least one embodiment, the cartridge body 902 consists of a compressible hemostat material such as, for example, oxidized regenerated cellulose (“ORC”) or a bio-absorbable foam fabricated from, for example, PGA (Polyglycolic acid, sold under the trademark Vicryl), PCL (polycaprolactone), PLA or PLLA (Polyactic acid), PDS, (Polydioxanone), PHA (polyhydroxyalkanoate), PGCL (poliglecaprone 25, sold under the trademark Monocryl) or a composite of PGA, PCL, PLA and PDS in which lines 920, 930 of unformed staples 922 are supported. However, the cartridge body 902 may be fabricated from other materials that serve to support the unformed staples 922 in a desired orientation such that they may be compressed as the anvil 910 is brought into contact therewith. As with various other embodiments described above, the staple cartridge 900 is implantable and is left attached to the stapled tissue after the stapling procedure has been completed. In at least some embodiments, in order to prevent the staples 922 from being affected and the hemostat material from being activated during the introduction and positioning process, the entire cartridge 900 may be coated or wrapped in a biodegradable film 906 such as a polydioxanon film sold under the trademark PDS® or with a Polyglycerol sebacate (PGS) film or other biodegradable films fabricated from, for example, PGA (Polyglycolic acid, marketed under the trade mark Vicryl), PCL (Polycaprolactone), PLA or PLLA (Polylactic acid), PHA (polyhydroxyalkanoate), PGCL (poliglecaprone 25, sold under the trademark Monocryl) or a composite of PGA, PCL, PLA, PDS that would be impermeable until ruptured. The cartridge body 902 of staple cartridge 900 is sized to be removably supported within the elongated channel 614 of the end effector 612′.

In the embodiment depicted in FIGS. 69, 73, and 74, the surgical staple cartridge 900 operably supports a first line 920 of staples 922 on one lateral side 907 of the elongated slot 904 and a second line 930 of staples 922 on the other lateral side 909 of the elongated slot 904. In various embodiments, the staples 922 may be fabricated from a metal material such as, for example, Titanium, Titanium alloys (e.g., 6AI-4V Titanium, 3a1-2.5V Titanium), Stainless Steel, etc. and have a staple base 924 and two upstanding staple legs 926 protruding therefrom. Each staple leg 926 may have a tissue-piercing tip 928 formed thereon. In the first line 920 of staples 922, the staple base 924 of at least one staple 922 overlaps the staple base of another staple 922. In a preferred embodiment, the staple base 924 of each staple 922 overlaps the staple bases 924 of two adjacent staples 922, except for the base 924 of the last staple 922 on each end of the first staple line 920. See FIG. 73. Thus, the first staple line 920 has a substantially non-linear shape. More particularly, when viewed from above, the first staple line 920 has a substantially zigzag appearance.

As can be seen in FIG. 72, the anvil 90 has two sequential longitudinal staple forming pockets 912 that each has a substantial zigzag shape that corresponds to the shape of the first line 920 of staples 922 such that, when the anvil 910 is brought into forming contact with the staples 922, the legs 926 thereof are formed as shown in FIG. 74. Thus, the distal leg of one staple shares the same pocket as the proximal leg of the next staple longitudinally. Such arrangement allows for a denser pocket pattern, even to a point where the staples themselves interact (e.g., are folded over one another). In prior staple pocket arrangements, in general, there has to be between 0.005 and 0.015 inches of metal/space from one set of pockets to the next. This embodiment of the present invention, however, has a spacing arrangement from 0 to 0.02 inches of interference/overlap (essentially a −0.020″) because one staple mates with the next staple, for example. Such arrangements allow for 15-30% more staples in the same space. Furthermore, when the staples interlock, there is less need for multiple lateral rows of staples. Prior arrangements commonly employ three rows on each side of the tissue cut line to prevent the existing of an open path through which blood may pass. Lines of interlocking staples are less likely to leave paths through which blood may pass. Another distinct advantage provided by the various interlocking staple arrangements of the present invention relates to improved “burst strength” which relates to the amount of force required to tear a staple line open.

Another staple forming pocket arrangement of the present invention may comprise a common staple forming pocket. As used herein, the term “common staple forming pocket” means that one forming pocket can form all of the staples in a single line of staples as opposed to prior anvil designs wherein a discrete forming pocket is provided for each leg of each staple to be formed.

FIG. 75 illustrates yet another staple embodiment 922′ wherein the base 924′ has an offset portion 928 to facilitate a tighter overlap of the bases 924′. As indicated above, the staple cartridge 900 has a second line 930 of staples 922 supported on a second lateral side 909 of the elongated slot 904. The second line 930 of staples 922 is substantially identical to the first line 920 of staples 922. Thus, the anvil 910 has a second common staple forming pocket 912 that corresponds to the second line of staples 930 for forming contact therewith. In alternative embodiments, however, the second line 930 of staples 922 may differ from the first line 920 of staples in shape and, perhaps, number of staples.

FIG. 71 illustrates a surgical staple cartridge 900′ that is substantially identical to the staple cartridge 900 described above, with the exception of the lines 920′, 930′ of staples 922 supported therein. For example, in this embodiment, the line 920′ of staples 922 are arranged relative to each other such that a base axis S-S of at least one staple base 924 is substantially transverse to the base axis S-S of the staple base 924 of at least one other adjacent staple 922. Such predetermined pattern of staples, when viewed from above, comprises a substantially zigzag arrangement. In the embodiment depicted in FIG. 76, the respective bases 924 of staples 922 may additionally have a base support member 927 overmolded thereon as shown. In various embodiments, the base support member 927 may be fabricated from, for example, non-absorbable plastic such as Polyether ether ketone “PEEK” or absorbable plastic such as, for example, Polyglycolic acid “PGA”, Polylactic acid “PLA” or “PLLA”, Polydioxanone “PDS”, PCL (polycaprolactone), PHA (polyhydroxyalkanoate), PGCL (poliglecaprone 25, sold under the trademark Monocryl) or various composite mixes if PGS, PDS, PLA, PGA, and PCL. The base support members 927 facilitate interlocking between the staples without making the staples themselves overlap. Thus, such arrangements could form staples with “B” shapes or inverted “W” shapes without the legs of the staples themselves overlapping. However, the crowns are connected by the base support members so they act like overlapping staples. Such arrangements allow the combined pockets to have two discrete paths for each leg.

The embodiment depicted in FIG. 77 employs a staple line 920″ wherein the legs 926 of adjacent staples 922 are coupled together by a coupler portion 929 molded or otherwise attached thereto. Each coupler portion 929 may be fabricated from, for example, Polyether ether ketone “PEEK” or absorbable plastic such as, for example, Polyglycolic acid “PGA”, Polylactic acid “PLA” or “PLLA”, Polydioxanone “PDS”, PCL (polycaprolactone), PHA (polyhydroxyalkanoate), PGCL (poliglecaprone 25, sold under the trademark Monocryl) or various composite mixes if PGS, PDS, PLA, PGA, and PCL. Such staple line 920″ has substantial zigzag appearance when viewed from above. While the various surgical staple cartridge embodiments 900, 900′ have been explained with reference to use with the end effectors 612′ and the surgical stapling instrument 610, it will be understood that the staple cartridges 900, 900′ may be effectively employed with the various other end effectors and surgical instruments described hereinabove, with appropriate staple forming pocket arrangements being provided in the anvils of those instruments in order to achieved the desired amount of staple formation upon movement of the anvils into forming contact with the staples.

FIGS. 78 and 79 illustrate another surgical staple cartridge 940 embodiment supported in an elongated channel 14 of a surgical instrument 10 of the present invention. In at least one embodiment, the surgical staple cartridge 940 includes a cartridge body 942 that has a centrally disposed elongated slot 944 extending at least partially therethrough. The elongated slot 944 is configured to permit a knife body of the surgical instrument 10 to axially move therethrough during a tissue cutting operation in the manner described above. In various embodiments, the cartridge body 942 consists of a compressible hemostat material such as, for example, oxidized regenerated cellulose (“ORC”) or a bio-absorbable foam of the types described above or below in which lines 946, 948, 950, 952 of unformed staples 922 are supported. In at least some embodiments, in order to prevent the staples 922 from being affected and the hemostat material from being activated during the introduction and positioning process, the entire cartridge 940 may be coated or wrapped in a biodegradable film 954 such as a polydioxanon film sold under the trademark PDS® or with a Polyglycerol sebacate (PGS) film or other biodegradable films fabricated from, for example, PGA (Polyglycolic acid, marketed under the trade mark Vicryl), PCL (Polycaprolactone), PLA or PLLA (Polylactic acid), PHA (polyhydroxyalkanoate), PGCL (poliglecaprone 25, sold under the trademark Monocryl) or a composite of PGA, PCL, PLA, PDS that would be impermeable until ruptured.

In the embodiment depicted in FIG. 78, the cartridge 940 further includes a cartridge support member 960 that is coupled to the cartridge body 942. In various embodiments, the cartridge support member 960 may be fabricated from a rigid material such as, for example, Titanium, Stainless Steel, Aluminum, any alloy of the foregoing, etc. and may be partially embedded within the cartridge body 942. In various embodiments, the cartridge support member 960 may be held in place by, for example, film 954. In still other embodiments wherein a limited bond is desired, sporadic use of cyanoacylate could be used to “glue” the two components together. In yet other embodiments, the cartridge body 942 may be heated and “welded” or “fused” to the cartridge support member 960. In various embodiments, the cartridge support member 960 forms at least a portion of the bottom surface of the cartridge body 942 for mating with the elongated channel 14. In a preferred embodiment, the cartridge support member 960 has one or more snap features 962 protruding therefrom for releasably coupling the cartridge support member 960 to the elongated channel 14. Other forms of snap features/fastener arrangements may be employed for releasably coupling the cartridge support member 960 to the elongated channel 14.

In various embodiments, the cartridge support member 960 has a series of support ridges 964, 966, 968, 970, 972, 974, 976 formed thereon to provide some lateral support to the bases 924 of the staples 922 in the staple lines 946, 948, 950, 952 as shown in FIG. 78. Thus, in at least some embodiments, the support ridges are substantially coextensive with the staple lines. FIG. 80 illustrates an alternative staple cartridge embodiment 940′ that is substantially identical to cartridge 940, except for the inclusion of upstanding fin portions 978, 979, 980, 981, 982, 983 that protrude from the support ridges 964, 966, 968, 970, 972, 976, respectively to provide additional lateral support to the staples 922. In various embodiments, the fin portions may be integrally formed with the cartridge support member 960 and have a height that is about ½ or less of the height of the cartridge. Thus, in preferred embodiments, for example, any standing features supporting the foam cannot extend above the maximum compression height of the foam. Thus, if the cartridge is designed, for example, to compress to ⅓ of its original height when fired, the fins would between 66% of the uncompressed height, all the way down to 10% of uncompressed height.

In use, once the staples 922 have been formed through contact with the anvil 20 in the manner described above, the anvil 20 is opened and the end effector 12 is pulled away from the stapled tissue. As the end effector 12 is pulled away from the stapled tissue, the cartridge body 942 remains fastened to the stapled tissue and is then separated from the cartridge support member 960 which remains coupled to the elongated channel 14. In various embodiments, the cartridge support member 960 is provided with a color that differs from the color of the material comprising the cartridge body 942 as well as the color of the elongated channel 14. Such arrangement provides the surgeon with an easily recognizable indication that no staple cartridge is present within the end effector. Thus, the surgeon will not inadvertently attempt to reinsert/use the end effector without first installing a new staple cartridge therein. To do so, the surgeon simply disconnects the snap features of the cartridge support member 960 from the elongated channel 14 to enable the cartridge support member 960 of a new staple cartridge 940 to be placed therein. While the staple cartridges 940, 940′ have been explained with reference to surgical instrument 10, it will be understood that those cartridges may be effectively employed with many of the other surgical instrument embodiments disclosed herein without departing from the spirit and scope of the present invention.

FIGS. 81 and 82 illustrate use of a surgical instrument embodiment 10 in connection with an end effector 990 that is substantially identical to end effector 12 described above except for a closure lockout arrangement 991 that is movably coupled to or otherwise supported within the elongated channel 14. In various embodiments, the closure lockout arrangement 991 includes a lockout arm 992 that has a distal end 993 and a proximal end 994. The lockout arm 992 is pivotally coupled to the elongated channel about a pivot member or trunion 995. The distal end portion has a leaf spring 996 or other biasing member attached thereto to bias the lockout arm 992 into an actuated or locking position wherein the proximal end portion 994 engages the distal end 141 of the first firing collar 141 to prevent the first firing collar 140 to be distally advanced to a “fired” position. However, when a staple cartridge 30 is installed in the elongated channel 14, the staple cartridge 30 causes the lockout arm 992 to move into an unactuated or unlocked position such that the firing collar 140 may be advanced distally past the lockout arm 992 to complete the staple firing process. See FIG. 81.

When in the locked position, the firing collar 140 cannot be advanced distally to complete the firing process. In addition, the firing trigger 130 cannot be advanced to the fully fired position wherein the knife lockout bar 210 is moved to an unlocked position to thereby enable the surgeon to advance the knife bar 172. Thus, when there is no cartridge present within the end effector 990, the closure lockout arrangement 991 is in the locked position which ultimately prevents the knife bar 172 from being advanced. As such, the surgeon is unable to advance the knife bar 172 to cut tissue unless a cartridge 30 is present within the end effector 990. It will be understood that the closure lockout arrangement 991 as described above may be effectively incorporated into many of the surgical instrument embodiments disclosed herein without departing from the spirit and scope of the present invention.

In various embodiments, a staple cartridge can comprise a cartridge body and a plurality of staples stored within the cartridge body. In use, the staple cartridge can be introduced into a surgical site and positioned on a side of the tissue being treated. In addition, a staple-forming anvil can be positioned on the opposite side of the tissue. In various embodiments, the anvil can be carried by a first jaw and the staple cartridge can be carried by a second jaw, wherein the first jaw and/or the second jaw can be moved toward the other. Once the staple cartridge and the anvil have been positioned relative to the tissue, the staples can be ejected from the staple cartridge body such that the staples can pierce the tissue and contact the staple-forming anvil. Once the staples have been deployed from the staple cartridge body, the staple cartridge body can then be removed from the surgical site. In various embodiments disclosed herein, a staple cartridge, or at least a portion of a staple cartridge, can be implanted with the staples. In at least one such embodiment, as described in greater detail further below, a staple cartridge can comprise a cartridge body which can be compressed, crushed, and/or collapsed by the anvil when the anvil is moved from an open position into a closed position. When the cartridge body is compressed, crushed, and/or collapsed, the staples positioned within the cartridge body can be deformed by the anvil. Alternatively, the jaw supporting the staple cartridge can be moved toward the anvil into a closed position. In either event, in various embodiments, the staples can be deformed while they are at least partially positioned within the cartridge body. In certain embodiments, the staples may not be ejected from the staple cartridge while, in some embodiments, the staples can be ejected from the staple cartridge along with a portion of the cartridge body.

Referring now to FIGS. 83A-83D, a compressible staple cartridge, such as staple cartridge 1000, for example, can comprise a compressible, implantable cartridge body 1010 and, in addition, a plurality of staples 1020 positioned in the compressible cartridge body 1010, although only one staple 1020 is depicted in FIGS. 83A-83D. FIG. 83A illustrates the staple cartridge 1000 supported by a staple cartridge support, or staple cartridge channel, 1030, wherein the staple cartridge 1000 is illustrated in an uncompressed condition. In such an uncompressed condition, the anvil 1040 may or may not be in contact with the tissue T. In use, the anvil 1040 can be moved from an open position into contact with the tissue T as illustrated in FIG. 83B and position the tissue T against the cartridge body 1010. Even though the anvil 1040 can position the tissue T against a tissue-contacting surface 1019 of staple cartridge body 1010, referring again to FIG. 83B, the staple cartridge body 1010 may be subjected to little, if any, compressive force or pressure at such point and the staples 1020 may remain in an unformed, or unfired, condition. As illustrated in FIGS. 83A and 83B, the staple cartridge body 1010 can comprise one or more layers and the staple legs 1021 of staples 1020 can extend upwardly through these layers. In various embodiments, the cartridge body 1010 can comprise a first layer 1011, a second layer 1012, a third layer 1013, wherein the second layer 1012 can be positioned intermediate the first layer 1011 and the third layer 1013, and a fourth layer 1014, wherein the third layer 1013 can be positioned intermediate the second layer 1012 and the fourth layer 1014. In at least one embodiment, the bases 1022 of the staples 1020 can be positioned within cavities 1015 in the fourth layer 1014 and the staple legs 1021 can extend upwardly from the bases 1022 and through the fourth layer 1014, the third layer 1013, and the second layer 1012, for example. In various embodiments, each deformable leg 1021 can comprise a tip, such as sharp tip 1023, for example, which can be positioned in the second layer 1012, for example, when the staple cartridge 1000 is in an uncompressed condition. In at least one such embodiment, the tips 1023 may not extend into and/or through the first layer 1011, wherein, in at least one embodiment, the tips 1023 may not protrude through the tissue-contacting surface 1019 when the staple cartridge 1000 is in an uncompressed condition. In certain other embodiments, the sharp tips 1023 may be positioned in the third layer 1013, and/or any other suitable layer, when the staple cartridge is in an uncompressed condition. In various alternative embodiments, a cartridge body of a staple cartridge may have any suitable number of layers such as less than four layers or more than four layers, for example.

In various embodiments, as described in greater detail below, the first layer 1011 can be comprised of a buttress material and/or plastic material, such as polydioxanone (PDS) and/or polyglycolic acid (PGA), for example, and the second layer 1012 can be comprised of a bioabsorbable foam material and/or a compressible hemostatic material, such as oxidized regenerated cellulose (ORC), for example. In various embodiments, one or more of the first layer 1011, the second layer 1012, the third layer 1013, and the fourth layer 1014 may hold the staples 1020 within the staple cartridge body 1010 and, in addition, maintain the staples 1020 in alignment with one another. In various embodiments, the third layer 1013 can be comprised of a buttress material, or a fairly incompressible or inelastic material, which can be configured to hold the staple legs 1021 of the staples 1020 in position relative to one another. Furthermore, the second layer 1012 and the fourth layer 1014, which are positioned on opposite sides of the third layer 1013, can stabilize, or reduce the movement of, the staples 1020 even though the second layer 1012 and the fourth layer 1014 can be comprised of a compressible foam or elastic material. In certain embodiments, the staple tips 1023 of the staple legs 1021 can be at least partially embedded in the first layer 1011. In at least one such embodiment, the first layer 1011 and the third layer 1013 can be configured to co-operatively and firmly hold the staple legs 1021 in position. In at least one embodiment, the first layer 1011 and the third layer 1013 can each be comprised of a sheet of bioabsorbable plastic, such as polyglycolic acid (PGA) which is marketed under the trade name Vicryl, polylactic acid (PLA or PLLA), polydioxanone (PDS), polyhydroxyalkanoate (PHA), poliglecaprone 25 (PGCL) which is marketed under the trade name Monocryl, polycaprolactone (PCL), and/or a composite of PGA, PLA, PDS, PHA, PGCL and/or PCL, for example, and the second layer 1012 and the fourth layer 1014 can each be comprised of at least one hemostatic material or agent.

Although the first layer 1011 can be compressible, the second layer 1012 can be substantially more compressible than the first layer 1011. For example, the second layer 1012 can be about twice as compressible, about three times as compressible, about four times as compressible, about five times as compressible, and/or about ten times as compressible, for example, as the first layer 1011. Stated another way, the second layer 1012 may compress about two times, about three times, about four times, about five times, and/or about ten times as much as first layer 1011, for a given force. In certain embodiments, the second layer 1012 can be between about twice as compressible and about ten times as compressible, for example, as the first layer 1011. In at least one embodiment, the second layer 1012 can comprise a plurality of air voids defined therein, wherein the amount and/or size of the air voids in the second layer 1012 can be controlled in order to provide a desired compressibility of the second layer 1012. Similar to the above, although the third layer 1013 can be compressible, the fourth layer 1014 can be substantially more compressible than the third layer 1013. For example, the fourth layer 1014 can be about twice as compressible, about three times as compressible, about four times as compressible, about five times as compressible, and/or about ten times as compressible, for example, as the third layer 1013. Stated another way, the fourth layer 1014 may compress about two times, about three times, about four times, about five times, and/or about ten times as much as third layer 1013, for a given force. In certain embodiments, the fourth layer 1014 can be between about twice as compressible and about ten times as compressible, for example, as the third layer 1013. In at least one embodiment, the fourth layer 1014 can comprise a plurality of air voids defined therein, wherein the amount and/or size of the air voids in the fourth layer 1014 can be controlled in order to provide a desired compressibility of the fourth layer 1014. In various circumstances, the compressibility of a cartridge body, or cartridge body layer, can be expressed in terms of a compression rate, i.e., a distance in which a layer is compressed for a given amount of force. For example, a layer having a high compression rate will compress a larger distance for a given amount of compressive force applied to the layer as compared to a layer having a lower compression rate. This being said, the second layer 1012 can have a higher compression rate than the first layer 1011 and, similarly, the fourth layer 1014 can have a higher compression rate than the third layer 1013. In various embodiments, the second layer 1012 and the fourth layer 1014 can be comprised of the same material and can comprise the same compression rate. In various embodiments, the second layer 1012 and the fourth layer 1014 can be comprised of materials having different compression rate. Similarly, the first layer 1011 and the third layer 1013 can be comprised of the same material and can comprise the same compression rate. In certain embodiments, the first layer 1011 and the third layer 1013 can be comprised of materials having different compression rates.

As the anvil 1040 is moved toward its closed position, the anvil 1040 can contact tissue T and apply a compressive force to the tissue T and the staple cartridge 1000, as illustrated in FIG. 83C. In such circumstances, the anvil 1040 can push the top surface, or tissue-contacting surface 1019, of the cartridge body 1010 downwardly toward the staple cartridge support 1030. In various embodiments, the staple cartridge support 1030 can comprise a cartridge support surface 1031 which can be configured to support the staple cartridge 1000 as the staple cartridge 1000 is compressed between the cartridge support surface 1031 and the tissue-contacting surface 1041 of anvil 1040. Owing to the pressure applied by the anvil 1040, the cartridge body 1010 can be compressed and the anvil 1040 can come into contact with the staples 1020. More particularly, in various embodiments, the compression of the cartridge body 1010 and the downward movement of the tissue-contacting surface 1019 can cause the tips 1023 of the staple legs 1021 to pierce the first layer 1011 of cartridge body 1010, pierce the tissue T, and enter into forming pockets 1042 in the anvil 1040. As the cartridge body 1010 is further compressed by the anvil 1040, the tips 1023 can contact the walls defining the forming pockets 1042 and, as a result, the legs 1021 can be deformed or curled inwardly, for example, as illustrated in FIG. 83C. As the staple legs 1021 are being deformed, as also illustrated in FIG. 83C, the bases 1022 of the staples 1020 can be in contact with or supported by the staple cartridge support 1030. In various embodiments, as described in greater detail below, the staple cartridge support 1030 can comprise a plurality of support features, such as staple support grooves, slots, or troughs 1032, for example, which can be configured to support the staples 1020, or at least the bases 1022 of the staples 1020, as the staples 1020 are being deformed. As also illustrated in FIG. 83C, the cavities 1015 in the fourth layer 1014 can collapse as a result of the compressive force applied to the staple cartridge body 1010. In addition to the cavities 1015, the staple cartridge body 1010 can further comprise one or more voids, such as voids 1016, for example, which may or may not comprise a portion of a staple positioned therein, that can be configured to allow the cartridge body 1010 to collapse. In various embodiments, the cavities 1015 and/or the voids 1016 can be configured to collapse such that the walls defining the cavities and/or walls deflect downwardly and contact the cartridge support surface 1031 and/or contact a layer of the cartridge body 1010 positioned underneath the cavities and/or voids.

Upon comparing FIG. 83B and FIG. 83C, it is evident that the second layer 1012 and the fourth layer 1014 have been substantially compressed by the compressive pressure applied by the anvil 1040. It may also be noted that the first layer 1011 and the third layer 1013 have been compressed as well. As the anvil 1040 is moved into its closed position, the anvil 1040 may continue to further compress the cartridge body 1010 by pushing the tissue-contacting surface 1019 downwardly toward the staple cartridge support 1030. As the cartridge body 1010 is further compressed, the anvil 1040 can deform the staples 1020 into their completely-formed shape as illustrated in FIG. 83D. Referring to FIG. 83D, the legs 1021 of each staple 1020 can be deformed downwardly toward the base 1022 of each staple 1020 in order to capture at least a portion of the tissue T, the first layer 1011, the second layer 1012, the third layer 1013, and the fourth layer 1014 between the deformable legs 1021 and the base 1022. Upon comparing FIGS. 83C and 83D, it is further evident that the second layer 1012 and the fourth layer 1014 have been further substantially compressed by the compressive pressure applied by the anvil 1040. It may also be noted upon comparing FIGS. 83C and 83D that the first layer 1011 and the third layer 1013 have been further compressed as well. After the staples 1020 have been completely, or at least sufficiently, formed, the anvil 1040 can be lifted away from the tissue T and the staple cartridge support 1030 can be moved away, and/or detached from, the staple cartridge 1000. As depicted in FIG. 83D, and as a result of the above, the cartridge body 1010 can be implanted with the staples 1020. In various circumstances, the implanted cartridge body 1010 can support the tissue along the staple line. In some circumstances, a hemostatic agent, and/or any other suitable therapeutic medicament, contained within the implanted cartridge body 1010 can treat the tissue over time. A hemostatic agent, as mentioned above, can reduce the bleeding of the stapled and/or incised tissue while a bonding agent or tissue adhesive can provide strength to the tissue over time. The implanted cartridge body 1010 can be comprised of materials such as ORC (oxidized regenerated cellulous), protein matrix, polyglycolic acid (PGA) which is marketed under the trade name Vicryl, polylactic acid (PLA or PLLA), polydioxanone (PDS), polyhydroxyalkanoate (PHA), poliglecaprone 25 (PGCL) which is marketed under the trade name Monocryl, polycaprolactone (PCL), and/or a composite of PGA, PLA, PDS, PHA, PGCL and/or PCL, for example. In certain circumstances, the cartridge body 1010 can comprise an antibiotic and/or anti-microbial material, such as colloidal silver and/or triclosan, for example, which can reduce the possibility of infection in the surgical site.

In various embodiments, the layers of the cartridge body 1010 can be connected to one another. In at least one embodiment, the second layer 1012 can be adhered to the first layer 1011, the third layer 1013 can be adhered to the second layer 1012, and the fourth layer 1014 can be adhered to the third layer 1013 utilizing at least one adhesive, such as fibrin and/or protein hydrogel, for example. In certain embodiments, although not illustrated, the layers of the cartridge body 1010 can be connected together by interlocking mechanical features. In at least one such embodiment, the first layer 1011 and the second layer 1012 can each comprise corresponding interlocking features, such as a tongue and groove arrangement and/or a dovetail joint arrangement, for example. Similarly, the second layer 1012 and the third layer 1013 can each comprise corresponding interlocking features while the third layer 1013 and the fourth layer 1014 can each comprise corresponding interlocking features. In certain embodiments, although not illustrated, the staple cartridge 1000 can comprise one or more rivets, for example, which can extend through one or more layers of the cartridge body 1010. In at least one such embodiment, each rivet can comprise a first end, or head, positioned adjacent to the first layer 1011 and a second head positioned adjacent to the fourth layer 1014 which can be either assembled to or formed by a second end of the rivet. Owing to the compressible nature of the cartridge body 1010, in at least one embodiment, the rivets can compress the cartridge body 1010 such that the heads of the rivets can be recessed relative to the tissue-contacting surface 1019 and/or the bottom surface 1018 of the cartridge body 1010, for example. In at least one such embodiment, the rivets can be comprised of a bioabsorbable material, such as polyglycolic acid (PGA) which is marketed under the trade name Vicryl, polylactic acid (PLA or PLLA), polydioxanone (PDS), polyhydroxyalkanoate (PHA), poliglecaprone 25 (PGCL) which is marketed under the trade name Monocryl, polycaprolactone (PCL), and/or a composite of PGA, PLA, PDS, PHA, PGCL and/or PCL, for example. In certain embodiments, the layers of the cartridge body 1010 may not be connected to one another other than by the staples 1020 contained therein. In at least one such embodiment, the frictional engagement between the staple legs 1021 and the cartridge body 1010, for example, can hold the layers of the cartridge body 1010 together and, once the staples have been formed, the layers can be captured within the staples 1020. In certain embodiments, at least a portion of the staple legs 1021 can comprise a roughened surface or rough coating which can increase the friction forces between the staples 1020 and the cartridge body 1010.

As described above, a surgical instrument can comprise a first jaw including the staple cartridge support 1030 and a second jaw including the anvil 1040. In various embodiments, as described in greater detail further below, the staple cartridge 1000 can comprise one or more retention features which can be configured to engage the staple cartridge support 1030 and, as a result, releasably retain the staple cartridge 1000 to the staple cartridge support 1030. In certain embodiments, the staple cartridge 1000 can be adhered to the staple cartridge support 1030 by at least one adhesive, such as fibrin and/or protein hydrogel, for example. In use, in at least one circumstance, especially in laparoscopic and/or endoscopic surgery, the second jaw can be moved into a closed position opposite the first jaw, for example, such that the first and second jaws can be inserted through a trocar into a surgical site. In at least one such embodiment, the trocar can define an approximately 5 mm aperture, or cannula, through which the first and second jaws can be inserted. In certain embodiments, the second jaw can be moved into a partially-closed position intermediate the open position and the closed position which can allow the first and second jaws to be inserted through the trocar without deforming the staples 1020 contained in the staple cartridge body 1010. In at least one such embodiment, the anvil 1040 may not apply a compressive force to the staple cartridge body 1010 when the second jaw is in its partially-closed intermediate position while, in certain other embodiments, the anvil 1040 can compress the staple cartridge body 1010 when the second jaw is in its partially-closed intermediate position. Even though the anvil 1040 can compress the staple cartridge body 1010 when it is in such an intermediate position, the anvil 1040 may not sufficiently compress the staple cartridge body 1010 such that the anvil 1040 comes into contact with the staples 1020 and/or such that the staples 1020 are deformed by the anvil 1040. Once the first and second jaws have been inserted through the trocar into the surgical site, the second jaw can be opened once again and the anvil 1040 and the staple cartridge 1000 can be positioned relative to the targeted tissue as described above.

In various embodiments, referring now to FIGS. 84A-84D, an end effector of a surgical stapler can comprise an implantable staple cartridge 1100 positioned intermediate an anvil 1140 and a staple cartridge support 1130. Similar to the above, the anvil 1140 can comprise a tissue-contacting surface 1141, the staple cartridge 1100 can comprise a tissue-contacting surface 1119, and the staple cartridge support 1130 can comprise a support surface 1131 which can be configured to support the staple cartridge 1100. Referring to FIG. 84A, the anvil 1140 can be utilized to position the tissue T against the tissue contacting surface 1119 of staple cartridge 1100 without deforming the staple cartridge 1100 and, when the anvil 1140 is in such a position, the tissue-contacting surface 1141 can be positioned a distance 1101a away from the staple cartridge support surface 1131 and the tissue-contacting surface 1119 can be positioned a distance 1102a away from the staple cartridge support surface 1131. Thereafter, as the anvil 1140 is moved toward the staple cartridge support 1130, referring now to FIG. 84B, the anvil 1140 can push the top surface, or tissue-contacting surface 1119, of staple cartridge 1100 downwardly and compress the first layer 1111 and the second layer 1112 of cartridge body 1110. As the layers 1111 and 1112 are compressed, referring again to FIG. 84B, the second layer 1112 can be crushed and the legs 1121 of staples 1120 can pierce the first layer 1111 and enter into the tissue T. In at least one such embodiment, the staples 1120 can be at least partially positioned within staple cavities, or voids, 1115 in the second layer 1112 and, when the second layer 1112 is compressed, the staple cavities 1115 can collapse and, as a result, allow the second layer 1112 to collapse around the staples 1120. In various embodiments, the second layer 1112 can comprise cover portions 1116 which can extend over the staple cavities 1115 and enclose, or at least partially enclose, the staple cavities 1115. FIG. 84B illustrates the cover portions 1116 being crushed downwardly into the staple cavities 1115. In certain embodiments, the second layer 1112 can comprise one or more weakened portions which can facilitate the collapse of the second layer 1112. In various embodiments, such weakened portions can comprise score marks, perforations, and/or thin cross-sections, for example, which can facilitate a controlled collapse of the cartridge body 1110. In at least one embodiment, the first layer 1111 can comprise one or more weakened portions which can facilitate the penetration of the staple legs 1121 through the first layer 1111. In various embodiments, such weakened portions can comprise score marks, perforations, and/or thin cross-sections, for example, which can be aligned, or at least substantially aligned, with the staple legs 1121.

When the anvil 1140 is in a partially closed, unfired position, referring again to FIG. 84A, the anvil 1140 can be positioned a distance 1101a away from the cartridge support surface 1131 such that a gap is defined therebetween. This gap can be filled by the staple cartridge 1100, having a staple cartridge height 1102a, and the tissue T. As the anvil 1140 is moved downwardly to compress the staple cartridge 1100, referring again to FIG. 84B, the distance between the tissue contacting surface 1141 and the cartridge support surface 1131 can be defined by a distance 1101b which is shorter than the distance 1101a. In various circumstances, the gap between the tissue-contacting surface 1141 of anvil 1140 and the cartridge support surface 1131, defined by distance 1101b, may be larger than the original, undeformed staple cartridge height 1102a. As the anvil 1140 is moved closer to the cartridge support surface 1131, referring now to FIG. 84C, the second layer 1112 can continue to collapse and the distance between the staple legs 1121 and the forming pockets 1142 can decrease. Similarly, the distance between the tissue-contacting surface 1141 and the cartridge support surface 1131 can decrease to a distance 1101c which, in various embodiments, may be greater than, equal to, or less than the original, undeformed cartridge height 1102a. Referring now to FIG. 84D, the anvil 1140 can be moved into a final, fired position in which the staples 1120 have been fully formed, or at least formed to a desired height. In such a position, the tissue-contacting surface 1141 of anvil 1140 can be a distance 1101d away from the cartridge support surface 1131, wherein the distance 1101d can be shorter than the original, undeformed cartridge height 1102a. As also illustrated in FIG. 84D, the staple cavities 1115 may be fully, or at least substantially, collapsed and the staples 1120 may be completely, or at least substantially, surrounded by the collapsed second layer 1112. In various circumstances, the anvil 1140 can be thereafter moved away from the staple cartridge 1100. Once the anvil 1140 has been disengaged from the staple cartridge 1100, the cartridge body 1110 can at least partially re-expand in various locations, i.e., locations intermediate adjacent staples 1120, for example. In at least one embodiment, the crushed cartridge body 1110 may not resiliently re-expand. In various embodiments, the formed staples 1120 and, in addition, the cartridge body 1110 positioned intermediate adjacent staples 1120 may apply pressure, or compressive forces, to the tissue T which may provide various therapeutic benefits.

As discussed above, referring again to the embodiment illustrated in FIG. 84A, each staple 1120 can comprise staple legs 1121 extending therefrom. Although staples 1120 are depicted as comprising two staple legs 1121, various staples can be utilized which can comprise one staple leg or, alternatively, more than two staple legs, such as three staple legs or four staple legs, for example. As illustrated in FIG. 84A, each staple leg 1121 can be embedded in the second layer 1112 of the cartridge body 1110 such that the staples 1120 are secured within the second layer 1112. In various embodiments, the staples 1120 can be inserted into the staple cavities 1115 in cartridge body 1110 such that the tips 1123 of the staple legs 1121 enter into the cavities 1115 before the bases 1122. After the tips 1123 have been inserted into the cavities 1115, in various embodiments, the tips 1123 can be pressed into the cover portions 1116 and incise the second layer 1112. In various embodiments, the staples 1120 can be seated to a sufficient depth within the second layer 1112 such that the staples 1120 do not move, or at least substantially move, relative to the second layer 1112. In certain embodiments, the staples 1120 can be seated to a sufficient depth within the second layer 1112 such that the bases 1122 are positioned or embedded within the staple cavities 1115. In various other embodiments, the bases 1122 may not be positioned or embedded within the second layer 1112. In certain embodiments, referring again to FIG. 84A, the bases 1122 may extend below the bottom surface 1118 of the cartridge body 1110. In certain embodiments, the bases 1122 can rest on, or can be directly positioned against, the cartridge support surface 1130. In various embodiments, the cartridge support surface 1130 can comprise support features extending therefrom and/or defined therein wherein, in at least one such embodiment, the bases 1122 of the staples 1120 may be positioned within and supported by one or more support grooves, slots, or troughs, 1132, for example, in the staple cartridge support 1130, as described in greater detail further below.

Further to the above, referring now to FIG. 85, the bases 1122 of the staples 1120 can be positioned directly against the support surface 1131 of staple cartridge support 1130. In various embodiments, including embodiments where the staple bases 1122 comprise circular or arcuate bottom surfaces 1124, for example, the staple bases 1122 may move or slide along the staple cartridge support surface 1131. Such sliding can occur when the anvil 1140 is pressed against the tips 1123 of the staple legs 1121 during the staple forming process. In certain embodiments, as described above and referring now to FIG. 86, the staple cartridge support 1130 can comprise one or more support slots 1132 therein which can be configured to eliminate, or at least reduce, the relative movement between the staple bases 1122 and the cartridge support surface 1131. In at least one such embodiment, each support slot 1132 can be defined by a surface contour which matches, or at least substantially matches, the contour of the bottom surface of the staple positioned therein. For example, the bottom surface 1124 of the base 1122 depicted in FIG. 86 can comprise a circular, or at least substantially circular, surface and the support slot 1132 can also comprise a circular, or at least substantially circular, surface. In at least one such embodiment, the surface defining the slot 1132 can be defined by a radius of curvature which is greater than or equal to a radius of curvature which defines bottom surface 1124. Although the slots 1132 may assist in preventing or reducing relative sliding movement between the staples 1120 and the staple cartridge support 1130, the slots 1132 may also be configured to prevent or reduce relative rotational movement between the staples 1120 and the staple cartridge support 1130. More particularly, in at least one embodiment, the slots 1132 can be configured to closely receive the bases 1122 in order to prevent or reduce the rotation of the staples 1120 about axes 1129, for example, such that the staples 1120 do not rotate or twist when they are being deformed.

In various embodiments, further to the above, each staple 1120 can be formed from a round, or an at least substantially round, wire. In certain embodiments, the legs and the base of each staple can be formed from a wire having a non-circular cross-section, such as a rectangular cross-section, for example. In at least one such embodiment, the staple cartridge support 1130 can comprise corresponding non-circular slots, such as rectangular slots, for example, configured to receive the bases of such staples. In various embodiments, referring now to FIG. 87, each staple 1120 can comprise a crown, such as a crown 1125, for example, overmolded onto a base 1122 wherein each crown 1125 can be positioned within a support slot in the staple cartridge support 1130. In at least one such embodiment, each crown 1125 can comprise a square and/or rectangular cross-section, for example, which can be configured to be received within square and/or rectangular slots 1134, for example, in the staple cartridge support 1130. In various embodiments, the crowns 1125 can be comprised of a bioabsorbable plastic, such as polyglycolic acid (PGA) which is marketed under the trade name Vicryl, polylactic acid (PLA or PLLA), polydioxanone (PDS), polyhydroxyalkanoate (PHA), poliglecaprone 25 (PGCL) which is marketed under the trade name Monocryl, polycaprolactone (PCL), and/or a composite of PGA, PLA, PDS, PHA, PGCL and/or PCL, for example, and can be formed around the bases 1122 of the staples 1120 by an injection molding process, for example. Various crowns and methods for forming various crowns are disclosed in U.S. patent application Ser. No. 11/541,123, entitled SURGICAL STAPLES HAVING COMPRESSIBLE OR CRUSHABLE MEMBERS FOR SECURING TISSUE THEREIN AND STAPLING INSTRUMENTS FOR DEPLOYING THE SAME, filed on Sep. 29, 2006, now U.S. Pat. No. 7,794,475, the entire disclosure of which is incorporated be reference herein. Referring again to FIG. 87, the slots 1134 can further comprise lead-ins, or bevels, 1135 which can be configured to facilitate the insertion of the crowns 1125 into the slots 1134. In various embodiments, the bases and/or crowns of the staples 1120 may be positioned within the slots 1134 when the staple cartridge 1100 is assembled to the staple cartridge support 1130. In certain embodiments, the crowns 1125 of the staples 1120 may be aligned with the slots 1134 when the staple cartridge 1100 is assembled to the staple cartridge support 1130. In at least one such embodiment, the crowns 1125 may not enter into the slots 1134 until a compressive force is applied to the staple legs 1121 and the bases and/or crowns of the staples 1120 are pushed downwardly into the slots 1134.

In various embodiments, referring now to FIGS. 88 and 89, a staple cartridge, such as staple cartridge 1200, for example, can comprise a compressible, implantable cartridge body 1210 comprising an outer layer 1211 and an inner layer 1212. Similar to the above, the staple cartridge 1200 can comprise a plurality of staples 1220 positioned within the cartridge body 1210. In various embodiments, each staple 1220 can comprise a base 1222 and one or more staple legs 1221 extending therefrom. In at least one such embodiment, the staple legs 1221 can be inserted into the inner layer 1212 and seated to a depth in which the bases 1222 of the staples 1220 abut and/or are positioned adjacent to the bottom surface 1218 of the inner layer 1212, for example. In the embodiment depicted in FIGS. 88 and 89, the inner layer 1212 does not comprise staple cavities configured to receive a portion of the staples 1220 while, in other embodiments, the inner layer 1212 can comprise such staple cavities. In various embodiments, further to the above, the inner layer 1212 can be comprised of a compressible material, such as bioabsorbable foam and/or oxidized regenerated cellulose (ORC), for example, which can be configured to allow the cartridge body 1210 to collapse when a compressive load is applied thereto. In various embodiments, the inner layer 1212 can be comprised of a lyophilized foam comprising polylactic acid (PLA) and/or polyglycolic acid (PGA), for example. The ORC may be commercially available under the trade name Surgicel and can comprise a loose woven fabric (like a surgical sponge), loose fibers (like a cotton ball), and/or a foam. In at least one embodiment, the inner layer 1212 can be comprised of a material including medicaments, such as freeze-dried thrombin and/or fibrin, for example, contained therein and/or coated thereon which can be water-activated and/or activated by fluids within the patient's body, for example. In at least one such embodiment, the freeze-dried thrombin and/or fibrin can be held on a Vicryl (PGA) matrix, for example. In certain circumstances, however, the activatable medicaments can be unintentionally activated when the staple cartridge 1200 is inserted into a surgical site within the patient, for example. In various embodiments, referring again to FIGS. 88 and 89, the outer layer 1211 can be comprised of a water impermeable, or at least substantially water impermeable, material such that liquids do not come into contact with, or at least substantially contact, the inner layer 1212 until after the cartridge body 1210 has been compressed and the staple legs have penetrated the outer layer 1211 and/or after the outer layer 1211 has been incised in some fashion. In various embodiments, the outer layer 1211 can be comprised of a buttress material and/or plastic material, such as polydioxanone (PDS) and/or polyglycolic acid (PGA), for example. In certain embodiments, the outer layer 1211 can comprise a wrap which surrounds the inner layer 1212 and the staples 1220. More particularly, in at least one embodiment, the staples 1220 can be inserted into the inner layer 1212 and the outer layer 1211 can be wrapped around the sub-assembly comprising the inner layer 1212 and the staples 1220 and then sealed.

In various embodiments, referring now to FIGS. 90 and 91, a staple cartridge, such as staple cartridge 1300, for example, can comprise a compressible, implantable cartridge body 1310 including an outer layer 1311 and an inner layer 1312. Similar to the above, the staple cartridge 1300 can further comprise staples 1320 positioned within the cartridge body 1310 wherein each staple 1320 can comprise a base 1322 and one or more legs 1321 extending therefrom. Similar to staple cartridge 1200, the bases 1322 of staples 1320 can extend below the bottom surface 1318 of the inner layer 1312 and the outer layer 1311 can surround the bases 1322. In at least one such embodiment, the outer layer 1311 can be sufficiently flexible so as to envelop each staple base 1322 such that the outer layer 1311 conforms to the contour of the bases 1322. In at least one alternative embodiment, referring again to FIG. 89, the outer layer 1211 can be sufficiently rigid such that it extends around the bases 1222 without conforming to each base 1222. In any event, in various embodiments, the outer layer 1311 can be positioned intermediate the bases 1322 of staples 1320 and a staple cartridge support surface, such as support surfaces 1031 or 1131, for example, supporting the staple cartridge 1300. In at least one such embodiment, the outer layer 1311 can be positioned intermediate the bases 1322 and support slots, such as slots 1032 or 1132, for example, defined in the staple cartridge support surface. In at least one such embodiment, further to the above, the outer layer 1311 can be configured to limit the movement of the bases 1322 and/or increase the coefficient of friction between the bases 1322 and the staple cartridge support surface and/or support slots in order to reduce relative movement therebetween. In various alternative embodiments, referring now to FIGS. 92 and 93, the outer layer of a staple cartridge, such as staple cartridge 1400, for example, may not entirely surround the staples positioned therein. In at least one such embodiment, an outer layer 1411 of a compressible, implantable cartridge body 1410 may be assembled to the inner layer 1412 before the staple legs 1421 of staples 1420 are inserted into the cartridge body 1410. As a result of the above, the bases 1422 of staples 1420 may extend outside of the outer layer 1411 and, in at least one such embodiment, the bases 1422 may be positioned directly into the support slots 1032 or 1132 within the staple cartridge support surfaces 1031 or 1131, for example. In various embodiments, the staple legs 1421 may incise the outer layer 1411 when they are inserted therethrough. In various circumstances, the holes created by the staple legs 1421 may closely surround the staple legs 1421 such that very little, if any, fluid can leak between the staple legs 1421 and the outer layer 1411 which can reduce the possibility of, or prevent, the medicament contained within the staple cartridge body 1410 from being activated and/or leaking out of the cartridge body 1410 prematurely.

As discussed above, referring again to FIGS. 88 and 89, the legs 1221 of the staples 1220 can be embedded within the cartridge body 1210 and the bases 1222 of staples 1220 may extend outwardly from the bottom surface 1218 of the inner layer 1212. In various embodiments, further to the above, the inner layer 1212 may not comprise staple cavities configured to receive the staples 1220. In various other embodiments, referring now to FIGS. 94 and 95, a staple cartridge, such as staple cartridge 1500, for example, may comprise a compressible, implantable cartridge body 1510 comprising staple cavities 1515 which can be configured to receive at least a portion of the staples 1520 therein. In at least one such embodiment, a top portion of the staple legs 1521 of the staples 1520 may be embedded in the inner layer 1512 while a bottom portion of the staple legs 1521, and the bases 1522, may be positioned within the staple cavities 1515. In certain embodiments, the bases 1522 may be entirely positioned in the staple cavities 1515 while, in some embodiments, the bases 1522 may at least partially extend below the bottom surface 1518 of the inner layer 1512. Similar to the above, the outer layer 1511 may enclose the inner layer 1512 and the staples 1520 positioned therein. In certain other embodiments, referring now to FIG. 96, a staple cartridge 1600 may comprise staples 1620 positioned within staple cavities 1615 in a compressible, implantable cartridge body 1610 wherein at least a portion of the staples 1620 are not enclosed by the outer layer 1611. In at least one such embodiment, each staple 1620 can comprise staple legs 1621 which are at least partially embedded in the inner layer 1612 and, in addition, bases 1622 which extend outwardly around the outer layer 1611.

In various embodiments, referring now to FIGS. 97 and 98, a staple cartridge, such as staple cartridge 1700, for example, can comprise a compressible, implantable cartridge body 1710 and a plurality of staples 1720 at least partially positioned within the cartridge body 1710. The cartridge body 1710 can comprise an outer layer 1711, an inner layer 1712, and, in addition, an alignment matrix 1740 which can be configured to align and/or retain the staples 1720 in position within the cartridge body 1710. In at least one embodiment, the inner layer 1712 can comprise a recess 1741 which can be configured to receive the alignment matrix 1740 therein. In various embodiments, the alignment matrix 1140 can be press-fit within the recess 1741 and/or otherwise suitably secured to the inner layer 1712 utilizing at least one adhesive, such as fibrin and/or protein hydrogel, for example. In at least one embodiment, the recess 1741 can be configured such that the bottom surface 1742 of alignment matrix 1740 is aligned, or at least substantially aligned, with the bottom surface 1718 of the inner layer 1712. In certain embodiments, the bottom surface 1742 of the alignment matrix can be recessed with respect to and/or extend from the bottom surface 1718 of the second layer 1712. In various embodiments, each staple 1720 can comprise a base 1722 and one or more legs 1721 extending from the base 1722, wherein at least a portion of the staple legs 1721 can extend through the alignment matrix 1740. The alignment matrix 1740 can further comprise a plurality of apertures and/or slots, for example, extending therethrough which can be configured to receive the staple legs 1721 therein. In at least one such embodiment, each aperture can be configured to closely receive a staple leg 1721 such that there is little, if any, relative movement between the staple leg 1721 and the sidewalls of the aperture. In certain embodiments, the alignment matrix apertures may not extend entirely through the alignment matrix 1740 and the staple legs 1721 may be required to incise the alignment matrix 1740 as the staple legs 1721 are pushed therethrough.

In various embodiments, the alignment matrix 1740 can be comprised of a molded plastic body which, in at least one embodiment, can be stiffer or less compressible than the inner layer 1712 and/or the outer layer 1711. In at least one such embodiment, the alignment matrix 1740 can be comprised of a plastic material and/or any other suitable material, such as polydioxanone (PDS) and/or polyglycolic acid (PGA), for example. In certain embodiments, the alignment matrix 1740 can be assembled to the inner layer 1712 and the staple legs 1721 can thereafter be inserted through the alignment matrix 1740 and embedded into the inner layer 1712. In various embodiments, the bottom surface 1742 of the alignment matrix 1740 can comprise one or more grooves, slots, or troughs, for example, which can be configured to at least partially receive the bases 1722 of the staples 1720. Similar to the above, the outer layer 1711 can then be placed around the subassembly comprising the inner layer 1712, the alignment matrix 1740, and the staples 1720. Alternatively, the outer layer 1711 can be placed around a subassembly comprising the inner layer 1712 and the alignment matrix 1740 wherein the staples 1720 can be thereafter inserted through the outer layer 1711, the alignment matrix 1740, and the inner layer 1712. In any event, as a result of the above, the inner layer 1712, the alignment matrix 1740, and/or the outer layer 1711 can be configured to retain the staples 1720 in position until and/or after they are deformed by an anvil as described above. In at least one such embodiment, the alignment matrix 1740 can serve to hold the staples 1720 in place before the staple cartridge 1700 is implanted within a patient and, in addition, secure the tissue along the staple line after the staple cartridge 1700 has been implanted. In at least one embodiment, the staples 1720 may be secured within the alignment matrix 1740 without being embedded in the inner layer 1712 and/or the outer layer 1711, for example.

In various embodiments, referring now to FIGS. 99-105, a staple cartridge, such as staple cartridge 1800, for example, can be assembled by compressing an inner layer 1812, inserting staples, such as staples 1820, for example, into the inner layer 1812, and wrapping the inner layer 1812 with an outer layer 1811. Referring primarily to FIG. 99, a compressible inner layer 1812 is illustrated as comprising a plurality of staple cavities 1815 defined therein, although other embodiments are envisioned in which the inner layer 1812 does not comprise staple cavities, as described above. Referring now to FIG. 100, the compressible inner layer 1812 can be positioned intermediate a transfer plate 1850 and a support plate 1860 and compressed between the compression surfaces 1852 and 1862 thereof, respectively. As illustrated in FIG. 100, the top and bottom surfaces of the inner layer 1812 can be compressed toward one another and, in response thereto, the inner layer 1812 can bulge outwardly in the lateral directions. In certain embodiments, the inner layer 1812 can be compressed to a height which is approximately one-third of its original height, for example, and can have a height or thickness between approximately 0.06″ and approximately 0.08″ in its compressed state, for example. As also illustrated in FIG. 100, the transfer plate 1850 can further comprise a plurality of staples, such as staples 1820, for example, positioned within a plurality of staple wells 1853. In addition, the transfer plate 1850 can further comprise a plurality of drivers 1851 which can be configured to push the staples 1820 upwardly and out of the staple wells 1853. Referring now to FIG. 101, the drivers 1851 can be utilized to push the staple legs 1821 of the staples 1820 into and through the compressed inner layer 1812. In various embodiments, the drivers 1851 can be configured such that the top surfaces thereof are positioned flush, or at least nearly flush, with the compression surface 1852 of the transfer plate 1850 when the staples 1820 have been fully deployed from the staple wells 1853 of transfer plate 1850. In certain embodiments, as also illustrated in FIG. 101, the support plate 1860 can comprise a plurality of receiving apertures 1861 which can be configured to receive the staple legs 1821, or at least the tips of the staple legs 1821, after they are pushed through the inner layer 1812. The receiving apertures 1861, or the like, may be necessitated in embodiments where the inner layer 1812 has been compressed to a height which is shorter than the height of the staples 1820 and, thus, when the staples 1820 have been fully ejected from the staple wells 1853, the staple legs 1821 may protrude from the top surface of the compressed inner layer 1812. In certain other embodiments, the inner layer 1812 may be compressed to a height which is taller than the height of the staples 1820 and, as a result, the receiving apertures 1861 in support plate 1860 may be unnecessary.

After the staples 1820 have been inserted into the inner layer 1812, referring now to FIG. 102, the support plate 1860 can be moved away from the transfer plate 1850 in order to allow the inner layer 1812 to decompress. In such circumstances, the inner layer 1812 can resiliently re-expand to its original, or at least near-original, uncompressed height. As the inner layer 1812 re-expands, the height of the inner layer 1812 can increase such that it exceeds the height of the staples 1820 and such that the staple legs 1821 of the staples 1820 no longer protrude from the top surface of the inner layer 1812. In various circumstances, the receiving apertures 1861 can be configured to hold the staple legs 1821 in position at least until the support plate 1860 has been sufficiently moved away such that the legs 1821 are no longer positioned within the receiving apertures 1861. In such circumstances, the receiving apertures 1861 can assist in maintaining the relative alignment of the staples 1820 within the inner layer 1812 as it re-expands. In various circumstances, the inner layer 1812 and the staples 1820 positioned therein can comprise a subassembly 1801 which, referring now to FIG. 103, can be inserted into an outer layer 1811, for example. In at least one such embodiment, the outer layer 1811 can comprise a cavity 1802 defined therein which can be configured to receive the subassembly 1801 therein. In various circumstances, a tool, such as pliers 1855, for example, can be utilized to pull the outer layer 1811 onto the subassembly 1801. Once the subassembly 1801 has been sufficiently positioned within the outer layer 1811, referring now to FIG. 104, the outer layer 1811 can be sealed. In various embodiments, the outer layer 1811 can be sealed utilizing the application of heat energy to a portion thereof. More particularly, in at least one embodiment, the outer layer 1811 can be comprised of a plastic material wherein the open end of the outer layer 1811 can be heat-staked by one or more heated elements, or irons, 1856 in order to bond and/or seal the perimeter of the open end of the outer layer 1811 together. In at least one such embodiment, referring now to FIG. 105, an excess portion 1857 of the outer layer 1811 can be removed and the staple cartridge 1800 can then be used as described herein.

As described above, a staple cartridge can be positioned within and/or secured to a staple cartridge attachment portion. In various embodiments, referring now to FIGS. 106 and 107, a staple cartridge attachment portion can comprise a staple cartridge channel, such as staple cartridge channel 1930, for example, which can be configured to receive at least a portion of a staple cartridge, such as staple cartridge 1900, for example, therein. In at least one embodiment, the staple cartridge channel 1930 can comprise a bottom support surface 1931, a first lateral support wall 1940, and a second lateral support wall 1941. In use, the staple cartridge 1900 can be positioned within the staple cartridge channel 1930 such that the staple cartridge 1900 is positioned against and/or adjacent to the bottom support surface 1931 and positioned intermediate the first lateral support wall 1940 and the second lateral support wall 1941. In certain embodiments, the first lateral support wall 1940 and the second lateral support wall 1941 can define a lateral gap therebetween. In at least one such embodiment, the staple cartridge 1900 can comprise a lateral width 1903 which is the same as and/or wider than the lateral gap defined between the support walls 1940 and 1941 such that a compressible, implantable cartridge body 1910 of the staple cartridge 1900 can fit securely between the walls 1940 and 1941. In certain other embodiments, the lateral width 1903 of the staple cartridge 1900 can be shorter than the gap defined between the first and second side walls 1940 and 1941. In various embodiments, at least a portion of the walls 1940 and 1941 and the bottom support surface 1931 can be defined by a stamped metal channel while, in at least one embodiment, at least a portion of the lateral support wall 1940 and/or lateral support wall 1941 can be comprised of a flexible material, such as an elastomeric material, for example. Referring primarily to FIG. 106, the first side wall 1940 and the second side wall 1941 of the staple cartridge channel 1930 can each be comprised of a rigid portion 1933 extending upwardly from the bottom support surface 1931 and a flexible portion 1934 extending upwardly from the rigid portions 1933.

In various embodiments, further to the above, the cartridge body 1910 of staple cartridge 1900 can be comprised of one or more compressible layers, such as first layer 1911 and second layer 1912, for example. When the cartridge body 1910 is compressed against the bottom support surface 1931 by an anvil, as described above, the side portions of the cartridge body 1910 can expand laterally. In embodiments where the staple cartridge 1930 is comprised of rigid side walls, the lateral expansion of the cartridge body 1910 can be prevented, or at least limited, by the rigid side walls and, as a result, a significant amount of internal pressure, or stress, can be developed within the cartridge body 1910. In embodiments where at least a portion of the staple cartridge 1930 is comprised of flexible side walls, the flexible side walls can be configured to flex laterally and permit the side portions of the cartridge body 1910 to expand laterally, thereby reducing the internal pressure, or stress, generated within the cartridge body 1910. In embodiments where the cartridge channel does not comprise lateral side walls, or comprises lateral sidewalls which are relatively shorter than the staple cartridge, the side portions of the staple cartridge may expand laterally uninhibited, or at least substantially uninhibited. In any event, referring now to FIG. 107, a staple cartridge channel 2030 can comprise lateral sidewalls 2040 and 2041 which can be entirely comprised of a flexible material, such as an elastomeric material, for example. The staple cartridge channel 2030 can further comprise lateral slots 2033 extending along the sides of the bottom support surface 2031 of the staple cartridge channel 2030 which can be configured to receive and secure at least a portion of the lateral sidewalls 2040 and 2041 therein. In certain embodiments, the lateral side walls 2040 and 2041 can be secured in the slots 2033 via a snap-fit and/or press-fit arrangement while, in at least some embodiments, the lateral side walls 2040 and 2041 can be secured in the slots 2033 by one or more adhesives. In at least one embodiment, the sidewalls 2040 and 2041 may be detachable from the bottom support surface 2031 during use. In any event, a compressible, implantable cartridge body 2010 can be detached and/or disengaged from the lateral side walls 2040 and 2041 when the cartridge body 2010 is implanted with the staples 2020.

In various embodiments, referring now to FIG. 108, a surgical instrument can comprise a shaft 2150 and an end effector extending from the distal end of the shaft 2150. The end effector can comprise, similar to the above, a staple cartridge channel 2130, an anvil 2140 movable between an open position and a closed position, and a staple cartridge 2100 positioned intermediate the staple cartridge channel 2130 and the anvil 2140. Also similar to the above, the staple cartridge 2100 can comprise a compressible, implantable cartridge body 2110 and a plurality of staples 2120 positioned in the cartridge body 2110. In various embodiments, the staple cartridge channel 2130 can comprise, one, a bottom support surface 2131 against which the staple cartridge 2100 can be positioned, two, a distal end 2135 and, three, a proximal end 2136. In at least one embodiment, as illustrated in FIG. 108, the staple cartridge 2100 can comprise a first end 2105 which can be positionable in the distal end 2135 of the staple cartridge channel 2130 and a second end 2106 which can be positionable in the proximal end 2136 of the staple cartridge channel 2130. In various embodiments, the distal end 2135 of the staple cartridge channel 2130 can comprise at least one distal retention feature, such as a retention wall 2137, for example, and, similarly, the proximal end 2136 can comprise at least one proximal retention feature, such as a retention wall 2138, for example. In at least one such embodiment, the distal retention wall 2137 and the proximal retention wall 2138 can define a gap therebetween which can be equal to or less than the length of the staple cartridge 2100 such that the staple cartridge 2100 can fit securely within the staple cartridge channel 2130 when the staple cartridge 2100 is inserted therein.

In various embodiments, referring again to FIGS. 88 and 89, a staple cartridge, such as staple cartridge 1200, for example, can comprise a flat, or at least substantially flat, tissue-contacting surface 1219. In at least one such embodiment, the staple cartridge body 1210 of staple cartridge 1200 can comprise a first end 1205 which can be defined by a first height, or thickness, 1207 and a second end 1206 which can be defined by a second height, or thickness, 1208, wherein the first height 1207 can be equal to, or at least substantially equal to, the second height 1208. In certain embodiments, the cartridge body 1210 can comprise a constant, or at least substantially constant, height, or thickness, between the first end 1205 and the second end 1206. In at least one such embodiment, the tissue-contacting surface 1219 can be parallel, or at least substantially parallel, to the bottom surface 1218 of the cartridge body 1210. In various embodiments, referring once again to FIG. 108, the first end 2105 of the cartridge body 2110 of staple cartridge 2100 can be defined by a first height 2107 which is different than a second height 2108 of the second end 2106. In the illustrated embodiment, the first height 2107 is larger than the second height 2108, although the second height 2108 could be larger than the first height 2107 in alternative embodiments. In various embodiments, the height of the cartridge body 2110 can decrease linearly and/or geometrically between the first end 2105 and the second end 2106. In at least one such embodiment, the tissue-contacting surface 2119, which extends between the first end 2105 and the second end 2106, can be oriented along an angle defined therebetween. In at least one such embodiment, the tissue-contacting surface 2119 may not be parallel to the bottom surface 2118 of the cartridge body 2110 and/or parallel to the support surface 2131 of the staple cartridge channel 2130.

In various embodiments, referring again to FIGS. 108 and 109, the anvil 2140 can comprise a tissue-contacting surface 2141 which can be parallel, or at least substantially parallel, to the support surface 2131 of the staple cartridge channel 2130 when the anvil 2140 is in a closed position, as illustrated in FIG. 109. When the anvil 2140 is in a closed position, the anvil 2140 can be configured to compress the first end 2105 of the staple cartridge 2100 more than the second end 2106 owing to the taller height of the first end 2105 and the shorter height of the second end 2106. In some circumstances, including circumstances where the tissue T positioned intermediate the tissue contacting surfaces 2119 and 2141 has a constant, or at least substantially constant, thickness, the pressure generated within the tissue T and the cartridge 2100 can be greater at the distal end of the end effector than the proximal end of the end effector. More particularly, when the tissue T between the anvil 2140 and the staple cartridge 2100 has a substantially constant thickness, the tissue T positioned intermediate the distal end 2145 of the anvil 2140 and the first end 2105 of the staple cartridge 2100 can be more compressed than the tissue T positioned intermediate the proximal end 2146 of the anvil 2140 and the second end 2106 of the staple cartridge 2100. In various embodiments, a pressure gradient can be generated within the tissue T between the proximal end and the distal end of the end effector. More particularly, in at least one embodiment, when the tissue T between the anvil 2140 and the staple cartridge 2100 has a substantially constant thickness and the height of the staple cartridge 2100 decreases linearly from the distal end to the proximal end of the end effector, the pressure within the tissue T can decrease linearly from the distal end of the end effector to the proximal end of the end effector. Similarly, in at least one embodiment, when the tissue T between the anvil 2140 and the staple cartridge 2100 has a substantially constant thickness and the height of the staple cartridge 2100 decreases geometrically from the distal end to the proximal end of the end effector, the pressure within the tissue T can decrease geometrically from the distal end of the end effector to the proximal end of the end effector.

In various embodiments, referring again to FIG. 108, the tissue T positioned intermediate the staple cartridge 2100 and the anvil 2140 may not have a constant thickness throughout. In at least one such circumstance, the tissue T positioned between the proximal end 2146 of the anvil 2140 and the second end 2106 of the staple cartridge 2100 may be thicker than the tissue T positioned between the distal end 2145 of the anvil 2140 and the first end 2105 of the staple cartridge 2100. In such circumstances, as a result, the thicker tissue T may be generally positioned above the shorter proximal end 2106 of the staple cartridge 2100 and the thinner tissue T may be generally positioned above the taller distal end 2105. In use, the firing collar 2152 of the shaft 2150 can be advanced distally along the shaft spine 2151 such that the firing collar 2152 engages the cam portion 2143 of the anvil 2140 and rotates the anvil 2140 toward the staple cartridge 2100 as illustrated in FIG. 109. Once the anvil 2140 has been rotated into a fully-closed position, the tissue T may be compressed between the tissue-contacting surfaces 2119 and 2141 and, even though the height of the staple cartridge 2100 may not be constant between the proximal and distal ends of the end effector, the pressure or compressive forces applied to the tissue T may be constant, or at least substantially constant, thereacross. More particularly, as the thinner tissue T may be associated with the taller height of the staple cartridge 2100 and the thicker tissue T may be associated with the shorter height of the staple cartridge 2100, the cumulative, or summed, height of the tissue T and the staple cartridge 2100 may be constant, or at least substantially constant, between the proximal and distal ends of the end effector and, as a result, the compression of this cumulative height by the anvil 2140 may be constant, or at least substantially constant, thereacross.

In various embodiments, referring again to FIGS. 108 and 109, the staple cartridge 2100 can comprise an asymmetrical configuration. In at least one such embodiment, for example, the height of the staple cartridge 2100 at the first end 2105 thereof may be higher than the height of the staple cartridge 2100 at the second end 2106 thereof. In certain embodiments, the staple cartridge 2100 and/or the staple cartridge channel 2130 can comprise one or more alignment and/or retention features which can be configured to assure that the staple cartridge 2100 can only be positioned within the staple cartridge channel 2130 in one orientation, i.e., an orientation in which the first end 2105 is positioned in the distal end 2135 of the staple cartridge channel 2130 and the second end 2106 is positioned in the proximal end 2136. In various alternative embodiments, the staple cartridge 2100 and/or the staple cartridge channel 2130 can comprise one or more alignment and/or retention features which can be configured to permit the staple cartridge 2100 to be positioned within the staple cartridge channel 2130 in more than one orientation. Referring now to FIG. 110, for example, the staple cartridge 2100 can be positioned within the staple cartridge channel 2130 such that the first end 2105 of the staple cartridge 2100 can be positioned in the proximal end 2136 of the staple cartridge channel 2130 and the second end 2106 can be positioned in the distal end 2135. In various embodiments, as a result, the shorter height of the staple cartridge 2100 can be positioned proximate the distal retention wall 2137 and the taller height of the staple cartridge 2100 can be positioned proximate to the proximal retention wall 2138. In at least one such embodiment, the staple cartridge 2100 can be suitably arranged to apply a constant, or at least substantially constant, clamping pressure to tissue T having a thicker portion within the distal end of the end effector and a thinner portion within the proximal end of the end effector. In various embodiments, the staple cartridge 2100, for example, can be selectively oriented within the staple cartridge channel 2130. In at least one such embodiment, the alignment and/or retention features of the staple cartridge 2100 can be symmetrical and a surgeon can selectively orient the staple cartridge 2100 within the staple cartridge channel 2130 in the orientations depicted in FIG. 108 and FIG. 110, for example.

Further to the above, the implantable cartridge body 2110 can comprise a longitudinal axis 2109 which, when the staple cartridge 2100 is positioned in the staple cartridge channel 2130, can extend between the proximal and distal ends of the end effector. In various embodiments, the thickness of the cartridge body 2110 can generally decrease and/or generally increase between the first end 2105 and the second end 2106 along the longitudinal axis 2109. In at least one such embodiment, the distance, or height, between the bottom surface 2118 and the tissue-contacting surface 2119 can generally decrease and/or generally increase between the first end 2105 and the second end 2106. In certain embodiments, the thickness of the cartridge body 2110 can both increase and decrease along the longitudinal axis 2109. In at least one such embodiment, the thickness of the cartridge body 2110 can comprise one or more portions which increase in thickness and one or more portions which can decrease in thickness. In various embodiments, referring again to FIG. 110, the staple cartridge 2100 can comprise a plurality of staples 2120 positioned therein. In use, as described above, the staples 2120 can be deformed when the anvil 2140 is moved into a closed position. In certain embodiments, each staple 2120 can have the same, or at least substantially the same, height. In at least one such embodiment, the height of a staple can be measured from the bottom of the base of the staple to the top, or tip, of the tallest leg of the staple, for example.

In various embodiments, the staples within a staple cartridge can have different staple heights. In at least one such embodiment, a staple cartridge can comprise a first group of staples having a first staple height which are positioned in a first portion of a compressible cartridge body and a second group of staples having a second staple height which are positioned in a second portion of the compressible cartridge body. In at least one embodiment, the first staple height can be taller than the second staple height and the first group of staples can be positioned in the first end 2105 of the staple cartridge 2100 while the second group of staples can be positioned in the second end 2106. Alternatively, the taller first group of staples can be positioned in the second end 2106 of the staple cartridge 2100 while the shorter second group of staples can be positioned in the first end 2105. In certain embodiments, a plurality of staple groups, each group having a different staple height, can be utilized. In at least one such embodiment, a third group having an intermediate staple height can be positioned in the cartridge body 2110 intermediate the first group of staples and the second group of staples. In various embodiments, each staple within a staple row in the staple cartridge can comprise a different staple height. In at least one embodiment, the tallest staple within a staple row can be positioned on a first end of a staple row and the shortest staple can be positioned on an opposite end of the staple row. In at least one such embodiment, the staples positioned intermediate the tallest staple and the shortest staple can be arranged such that the staple heights descend between the tallest staple and the shortest staple, for example.

In various embodiments, referring now to FIG. 111, an end effector of a surgical stapler can comprise an anvil 2240, a staple cartridge channel 2230, and a staple cartridge 2200 supported by the staple cartridge channel 2230. The staple cartridge 2200 can comprise a compressible, implantable cartridge body 2210 and a plurality of staples, such as staples 2220a and staples 2220b, for example, positioned therein. In various embodiments, the staple cartridge channel 2230 can comprise a cartridge support surface 2231 and a plurality of staple support slots, such as support slots 2232a and 2232b, for example, defined therein. In at least one such embodiment, the staple cartridge 2200 can comprise two outer rows of staples 2220a and two inner rows of staples 2220b, wherein the support slots 2232a can be configured to support the staples 2220a and the support slots 2232b can be configured to support the staples 2220b. Referring to FIGS. 111 and 112, the anvil 2240 can comprise a plurality of staple forming pockets 2242 defined therein which can be configured to receive and deform the staples 2220a and 2220b when the anvil 2240 is moved toward the staple cartridge 2200. In at least one such embodiment, the bottom surfaces of the support slots 2232a can be a first distance 2201a away from the top surfaces of the staple forming pockets 2242 while the bottom surfaces of the support slots 2232b can be a second distance 2201b away from the top surfaces of the staple forming pockets 2242. In at least one such embodiment, the support slots 2232b are positioned closer to the anvil 2240 owing to the raised step in the support surface 2231 in which they are defined. Owing to the different distances 2201a and 2201b, in various embodiments, the outer rows of staples 2220a and the inner rows of staples 2220b can be deformed to different formed heights. In various circumstances, staples deformed to different formed heights can apply different clamping pressures or forces to the tissue T being stapled. In addition to the above, the staples can begin with different unformed staple heights. In at least one such embodiment, referring again to FIG. 111, the outer staples 2220a can have an initial, unformed height which is greater than the initial, unformed height of the inner staples 2220b. As illustrated in FIGS. 111 and 112, the inner staples 2220b, which have a shorter unformed height than the outer staples 2220a, can also have a shorter formed height than the outer staples 2220b. In various alternative embodiments, the inner staples 2220b may have a taller unformed height than the outer staples 2220a yet have a shorter deformed staple height than the outer staples 2220a.

In various embodiments, further to the above, the anvil 2240 can be moved into a closed position, as illustrated in FIG. 112, in order to compress the cartridge body 2210 and deform the staples 2220a and 2220b. In certain embodiments, a surgical stapler comprising the end effector depicted in FIGS. 111 and 112, for example, can further comprise a cutting member which can be configured to transect the tissue T positioned intermediate the anvil 2240 and the staple cartridge 2200. In at least one such embodiment, the anvil 2240, the staple cartridge channel 2230 and/or the staple cartridge 2200 can define a slot configured to slidably receive a cutting member therein. More particularly, the anvil 2240 can comprise a slot portion 2249, the staple cartridge channel 2230 can comprise a slot portion 2239, and the staple cartridge 2200 can comprise a slot portion 2203 which can be aligned, or at least substantially aligned, with one another when the anvil 2240 is in a closed, or at least substantially closed, position. In various embodiments, the cutting member can be moved from the proximal end of the end effector toward the distal end of the end effector after the anvil 2240 has been closed and the staples 2220a, 2220b have been deformed. In at least one embodiment, the cutting member can be moved independently of the staple deformation process. In certain embodiments, the cutting member can be advanced at the same time that the staples are being deformed. In any event, in at least one embodiment, the cutting member can be configured to incise the tissue along a path positioned intermediate the inner rows of staples 2220b.

In various embodiments, as illustrated in FIG. 112, the inner staples 2220b can be formed to a shorter height than the outer staples 2220a wherein the inner staples 2220b can apply a larger clamping pressure or force to the tissue adjacent to the cut line created by the cutting member. In at least one such embodiment, the larger clamping pressure or force created by the inner staples 2220b can provide various therapeutic benefits such as reducing bleeding from the incised tissue T while the smaller clamping pressure created by the outer staples 2220a can provide flexibility within the stapled tissue. In various embodiments, referring again to FIGS. 111 and 112, the anvil 2240 can further comprise at least one piece of buttress material, such as buttress material 2260, for example, attached thereto. In at least one such embodiment, the legs of the staples 2220a, 2220b can be configured to incise the buttress material 2260 and/or pass through apertures in the buttress material 2260 when the staple cartridge 2200 is compressed by the anvil 2240 and thereafter contact the staple forming pockets 2242 in the anvil 2240. As the legs of the staples 2220a, 2220b are being deformed, the legs can contact and/or incise the buttress material 2260 once again. In various embodiments, the buttress material 2260 can improve the hemostasis of and/or provide strength to the tissue being stapled.

In various embodiments, referring again to FIGS. 111 and 112, the bottom surface of the cartridge body 2210 can comprise a stepped contour which matches, or at least substantially matches, the stepped contour of the cartridge support surface 2231. In certain embodiments, the bottom surface of the cartridge body 2210 can deform to match, or at least substantially match, the contour of the cartridge support surface 2231. In various embodiments, referring now to FIG. 113, an end effector, similar to the end effector depicted in FIG. 111, for example, can comprise a staple cartridge 2300 positioned therein. The staple cartridge 2300 can comprise a compressible, implantable body 2310 comprising an inner layer 2312 and an outer layer 2311 wherein, further to the above, the outer layer 2311 can be comprised of a water impermeable material in at least one embodiment. In various embodiments, the outer layer 2311 can extend around the staples 2220a, 2220b and can be positioned intermediate the staples 2220a, 2220b and the support slots 2232a, 2232b, respectively. In various embodiments, referring now to FIG. 114, an end effector, similar to the end effector depicted in FIG. 111, for example, can comprise a staple cartridge 2400 positioned therein. Similar to the staple cartridge 2300, the compressible, implantable cartridge body 2410 of staple cartridge 2400 can comprise an inner layer 2412 and an outer layer 2411; however; in at least one embodiment, the cartridge body 2410 may not comprise a cutting member slot therein. In at least one such embodiment, the cutting member may be required to incise the inner layer 2412 and/or the outer layer 2411, for example, as it is advanced through the staple cartridge.

In various embodiments, referring now to FIG. 115, an end effector of a surgical stapler can comprise an anvil 2540, a staple cartridge channel 2530, and a staple cartridge 2500 positioned in the staple cartridge channel 2530. Similar to the above, the staple cartridge 2500 can comprise a compressible, implantable cartridge body 2510, outer rows of staples 2220a, and inner rows of staples 2220b. The staple cartridge channel 2530 can comprise a flat, or an at least substantially flat, cartridge support surface 2531 and staple support slots 2532 defined therein. The anvil 2540 can comprise a stepped surface 2541 and a plurality of staple forming pockets, such as forming pockets 2542a and 2542b, for example, defined therein. Similar to the above, the forming pockets 2542a and the support slots 2532 can define a distance therebetween which is greater than the distance between the forming pockets 2452b and the support slots 2532. In various embodiments, the anvil 2540 can further comprise a piece of buttress material 2560 attached to the stepped surface 2541 of the anvil 2540. In at least one such embodiment, the buttress material 2560 can conform, or at least substantially conform, to the stepped surface 2541. In various embodiments, the buttress material 2560 can be removably attached to the surface 2541 by at least one adhesive, such as fibrin and/or protein hydrogel, for example. In certain embodiments, the cartridge body 2510 can also comprise a stepped profile which, in at least one embodiment, parallels, or at least substantially parallels, the stepped surface 2541 of the anvil 2540. More particularly, in at least one embodiment, the anvil 2540 can comprise steps 2548 extending toward the staple cartridge 2500 wherein the steps 2548 can comprise a step height which equals, or at least substantially equals, the step height of the steps 2508 extending from the cartridge body 2510. In at least one such embodiment, as a result of the above, the amount of the compressible cartridge body 2510 that can be captured in the first staples 2220a can be different than the amount of the compressible cartridge body 2510 that can be captured in the second staples 2220b, for example.

In various embodiments, referring now to FIG. 116, an end effector can comprise an anvil 2640, a staple cartridge channel 2530, and a staple cartridge 2600 positioned therebetween. The staple cartridge 2600 can comprise a compressible, implantable cartridge body 2610 including an inner layer 2612, an outer layer 2611, and a plurality of staples, such as staples 2220a and 2200b, for example, positioned therein. In various embodiments, the anvil 2640 can comprise a plurality of staple forming pockets 2642 in surface 2641 and the staple cartridge channel 2530 can comprise a plurality of staple forming slots 2532 defined in the support surface 2531. As illustrated in FIG. 116, the anvil surface 2641 can be parallel, or at least substantially parallel, to the cartridge support surface 2531 wherein each forming pocket 2642 can be positioned an equal, or at least substantially equal, distance away from an opposing and corresponding staple support slot 2532. In various embodiments, the staple cartridge 2600 can comprise staples having the same, or at least substantially the same, initial, unformed staple height and, in addition, the same, or at least substantially the same, formed staple height. In certain other embodiments, the outer rows of staples can comprise staples 2220a and the inner rows of staples can comprise staples 2220b wherein, as discussed above, the staples 2220a and 2220b can have different unformed staple heights. When the anvil 2640 is moved toward the staple cartridge 2600 into a closed position, the staples 2220a and 2220b can be formed such that they have the same, or at least substantially the same, formed staple height. In at least one such embodiment, as a result of the above, the formed outer staples 2220a and the inner staples 2220b may have the same, or at least substantially the same, amount of compressible cartridge body 2610 contained therein; however, as the outer staples 2220a have a taller unformed staple height than the inner staples 2220b and may have the same formed staple height nonetheless, a greater clamping pressure can be generated in the outer staples 2220a than the inner staples 2220b, for example.

In various embodiments, referring now to FIG. 117, an end effector of a surgical stapler can comprise an anvil 2740, a staple cartridge channel 2530, and a staple cartridge 2700 positioned within the staple cartridge channel 2530. Similar to the above, the staple cartridge 2700 can comprise a compressible, implantable cartridge body 2710 comprising an inner layer 2712, an outer layer 2711, and a plurality of staples, such as staples 2220a and 2220b, for example, positioned therein. In at least one embodiment, the thickness of the cartridge body 2710 can vary across its width. In at least one such embodiment, the cartridge body 2710 can comprise a center portion 2708 and side portions 2709, wherein the center portion 2708 can comprise a thickness which is greater than the thickness of the side portions 2709. In various embodiments, the thickest portion of the cartridge body 2710 can be located at the center portion 2708 while the thinnest portion of the cartridge body 2710 can be located at the side portions 2709. In at least one such embodiment, the thickness of the cartridge body 2710 can decrease gradually between the center portion 2708 and the side portions 2709. In certain embodiments, the thickness of the cartridge body 2710 can decrease linearly and/or geometrically between the center portion 2708 and the side portions 2709. In at least one such embodiment, the tissue-contacting surface 2719 of cartridge body 2710 can comprise two inclined, or angled, surfaces which slope downwardly from the center portion 2708 toward the side portions 2709. In various embodiments, the anvil 2740 can comprise two inclined, or angled, surfaces which parallel, or at least substantially parallel, the inclined tissue-contacting surfaces 2719. In at least one embodiment, the anvil 2740 can further comprise at least one piece of buttress material 2760 attached to the inclined surfaces of the anvil 2740.

In various embodiments, further to the above, the inner rows of staples in the staple cartridge 2700 can comprise the taller staples 2220a and the outer rows of staples can comprise the shorter staples 2220b. In at least one embodiment, the taller staples 2220a can be positioned within and/or adjacent to the thicker center portion 2708 while the staples 2220b can be positioned within and/or adjacent to the side portions 2709. In at least one such embodiment, as a result of the above, the taller staples 2220a can capture more material of the implantable cartridge body 2710 than the shorter staples 2220b. Such circumstances could result in the staples 2220a applying a greater clamping pressure to the tissue T than the staples 2220b. In certain embodiments, even though the taller staples 2220a may capture more material of the cartridge body 2710 therein than the shorter staples 2220b, the taller staples 2220a may have a taller formed staple height than the shorter staples 2220b owing to the inclined arrangement of the staple forming pockets 2742a and 2742b. Such considerations can be utilized to achieve a desired clamping pressure within the tissue captured by the staples 2220a and 2220b wherein, as a result, the clamping pressure in the staples 2220a can be greater than, less than, or equal to the clamping pressure applied to the tissue by the staples 2220b, for example. In various alternative embodiments to the end effector illustrated in FIG. 117, the shorter staples 2220b can be positioned within and/or adjacent to the thicker center portion 2708 of the cartridge body 2710 and the taller staples 2220a can be positioned within and/or adjacent to the thinner side portions 2709. Furthermore, although the staple cartridge 2700 is depicted as comprising inner and outer rows of staples, the staple cartridge 2700 may comprise additional rows of staples, such as staple rows positioned intermediate the inner and outer rows of staples, for example. In at least one such embodiment, the intermediate staple rows can comprise staples having an unformed staple height which is intermediate the unformed staple heights of the staples 2220a and 2220b and a formed staple height which is intermediate the formed staple heights of the staples 2220a and 2220b, for example.

In various embodiments, referring now to FIG. 118, an end effector of a surgical stapler can comprise an anvil 2840, a staple cartridge channel 2530, and a staple cartridge 2800 positioned within the staple cartridge channel 2530. Similar to the above, the staple cartridge 2800 can comprise a compressible, implantable cartridge body 2810 comprising an inner layer 2812, an outer layer 2811, and a plurality of staples, such as staples 2220a and 2220b, for example, positioned therein. In at least one embodiment, the thickness of the cartridge body 2810 can vary across its width. In at least one such embodiment, the cartridge body 2810 can comprise a center portion 2808 and side portions 2809, wherein the center portion 2808 can comprise a thickness which is less than the thickness of the side portions 2809. In various embodiments, the thinnest portion of the cartridge body 2810 can be located at the center portion 2808 while the thickest portion of the cartridge body 2810 can be located at the side portions 2809. In at least one such embodiment, the thickness of the cartridge body 2810 can increase gradually between the center portion 2808 and the side portions 2809. In certain embodiments, the thickness of the cartridge body 2810 can increase linearly and/or geometrically between the center portion 2808 and the side portions 2809. In at least one such embodiment, the tissue-contacting surface 2819 of cartridge body 2810 can comprise two inclined, or angled, surfaces which slope upwardly from the center portion 2808 toward the side portions 2809. In various embodiments, the anvil 2840 can comprise two inclined, or angled, surfaces which parallel, or at least substantially parallel, the inclined tissue-contacting surfaces 2819. In at least one embodiment, the anvil 2840 can further comprise at least one piece of buttress material 2860 attached to the inclined surfaces of the anvil 2840. In various embodiments, further to the above, the outer rows of staples in the staple cartridge 2800 can comprise the taller staples 2220a and the inner rows of staples can comprise the shorter staples 2220b. In at least one embodiment, the taller staples 2220a can be positioned within and/or adjacent to the thicker side portions 2809 while the staples 2220b can be positioned within and/or adjacent to the center portion 2808. In at least one such embodiment, as a result of the above, the taller staples 2220a can capture more material of the implantable cartridge body 2810 than the shorter staples 2220b.

As described above with regard to the embodiment of FIG. 111, for example, the staple cartridge channel 2230 can comprise a stepped support surface 2231 which can be configured to support the staples 2220a and 2220b at different heights with respect the anvil 2240. In various embodiments, the staple cartridge channel 2230 can be comprised of metal and the steps in the support surface 2231 may be formed in the support surface 2231 by a grinding operation, for example. In various embodiments, referring now to FIG. 119, an end effector of a surgical instrument can comprise a staple cartridge channel 2930 comprising a support insert 2935 positioned therein. More particularly, in at least one embodiment, the staple cartridge channel 2930 can be formed such that it has a flat, or at least substantially flat, support surface 2931, for example, which can be configured to support the insert 2935 which comprises the stepped surfaces for supporting the staples 2220a and 2220b of the staple cartridge 2200 at different heights. In at least one such embodiment, the insert 2935 can comprise a flat, or at least substantially flat, bottom surface which can be positioned against the support surface 2931. The insert 2935 can further comprise support slots, grooves, or troughs 2932a and 2932b which can be configured to support the staples 2220a and 2220b, respectively, at different heights. Similar to the above, the insert 2935 can comprise a knife slot 2939 defined therein which can be configured to permit a cutting member to pass therethrough. In various embodiments, the staple cartridge channel 2930 can be comprised of the same material as or a different material than the support insert 2935. In at least one embodiment, the staple cartridge channel 2930 and the support insert 2935 can both be comprised of metal, for example, while, in other embodiments, the staple cartridge channel 2930 can be comprised of metal, for example, and the support insert 2935 can be comprised of plastic, for example. In various embodiments, the support insert 2935 can be fastened and/or welded into the staple cartridge channel 2930. In certain embodiments, the support insert 2935 can be snap-fit and/or press-fit into the staple cartridge channel 2930. In at least one embodiment the support insert 2935 can be secured in the staple cartridge channel 2930 using an adhesive.

In various embodiments, referring now to FIG. 120, an end effector of a surgical stapler can comprise an anvil 3040, a staple cartridge channel 3030, and a compressible, implantable staple cartridge 3000 positioned in the staple cartridge channel 3030. Similar to the above, the anvil 3040 can comprise a plurality of staple-forming pockets 3042 defined therein and a knife slot 3049 which can be configured to slidably receive a cutting member therein. Also similar to the above, the staple cartridge channel 3030 can comprise a plurality of staple support slots 3032 defined therein and a knife slot 3039 which can also be configured to slidably receive a cutting member therein. In various embodiments, the staple cartridge 3000 can comprise a first layer 3011, a second layer 3012, and a plurality of staples, such as staples 3020a and 3020b, for example, positioned therein. In at least one embodiment, the staples 3020a can comprise an unformed staple height which is taller than the unformed staple height of the staples 3020b. In various embodiments, the first layer 3011 can be comprised of a first compressible material and the second layer 3012 can be comprised of a second compressible material. In certain embodiments, the first compressible material can be compressed at a rate which is higher than the second compressible material while, in certain other embodiments, the first compressible material can be compressed at a rate which is lower than the second compressible material. In at least one embodiment, the first compressible material can be comprised of a resilient material which can comprise a first spring rate and the second compressible material can be comprised of a resilient material which can comprise a second spring rate which is different than the first spring rate. In various embodiments, the first compressible material can comprise a spring rate which is greater than the spring rate of the second compressible material. In certain other embodiments, the first compressible material can comprise a spring rate which is less than the spring rate of the second compressible material. In various embodiments, the first compressible layer can comprise a first stiffness and the second compressible layer can comprise a second stiffness, wherein the first stiffness is different than the second stiffness. In various embodiments, the first compressible layer can comprise a stiffness which is greater than the stiffness of the second compressible layer. In certain other embodiments, the first compressible layer can comprise a stiffness which is less than the stiffness of the second compressible layer.

In various embodiments, referring again to FIG. 120, the second layer 3012 of the staple cartridge 3000 can comprise a constant, or at least substantially constant, thickness across the width thereof. In at least one embodiment, the first layer 3011 can comprise a thickness which varies across the width thereof. In at least one such embodiment, the first layer 3011 can comprise one or more steps 3008 which can increase the thickness of the cartridge body 3010 in certain portions of the cartridge body 3010, such as the center portion, for example. Referring again to FIG. 120, the shorter staples 3020b can be positioned in or aligned with the steps 3008, i.e., the thicker portions of the cartridge body 3010, and the taller staples 3020a can be positioned in or aligned with the thinner portions of the cartridge body 3010. In various embodiments, as a result of the thicker and thinner portions of the cartridge body 3010, the stiffness of the cartridge body 3010 can be greater along the inner rows of staples 3020b than the outer rows of staples 3020a. In various embodiments, the first layer 3011 can be connected to the second layer 3012. In at least one such embodiment, the first layer 3011 and the second layer 3012 can comprise interlocking features which can retain the layers 3011 and 3012 together. In certain embodiments, the first layer 3011 can comprise a first laminate and the second layer 3012 can comprise a second laminate, wherein the first laminate can be adhered to the second laminate by one or more adhesives. In various embodiments, the staple cartridge 3000 can comprise a knife slot 3003 which can be configured to slidably receive a cutting member therein.

In various embodiments, referring now to FIG. 121, a staple cartridge 3100 can comprise a compressible, implantable cartridge body 3110 comprising a single layer of compressible material and, in addition, a plurality of staples, such as staples 3020b, for example, positioned therein. In at least one embodiment, the thickness of the cartridge body 3110 can vary across the width thereof. In at least one such embodiment, the cartridge body 3110 can comprise steps 3108 extending along the side portions thereof. In various embodiments, referring now to FIG. 122, a staple cartridge 3200 can comprise a compressible, implantable cartridge body 3210 comprising a single layer of compressible material and, in addition, a plurality of staples, such as staples 3020b, for example, positioned therein. In at least one embodiment, the thickness of the cartridge body 3210 can vary across the width thereof. In at least one such embodiment, the cartridge body 3210 can comprise steps 3208 extending along the center portion thereof. In various embodiments, referring now to FIG. 123, a staple cartridge 3300 can comprise a compressible, implantable cartridge body 3310 wherein, similar to the above, the thickness of the cartridge body 3310 can vary across the width thereof. In at least one embodiment, the thickness of the cartridge body 3310 can increase geometrically between the side portions and the center portion of the cartridge body 3310. In at least one such embodiment, the thickness of the cartridge body 3310 can be defined by an arcuate or curved profile and can comprise an arcuate or curved tissue-contacting surface 3319. In certain embodiments, the thickness of the cartridge body 3310, and the contour of the tissue-contacting surface 3319, can be defined by one radius of curvature or, alternatively, by several radiuses of curvature, for example. In various embodiments, referring now to FIG. 124, a staple cartridge 3400 can comprise a compressible, implantable cartridge body 3410 wherein the thickness of the cartridge body 3410 can increase linearly, or at least substantially linearly, between the side portions and the center portion of the cartridge body 3410.

In various embodiments, referring now to FIG. 125, a staple cartridge 3500 can comprise a compressible, implantable cartridge body 3510 and a plurality of staples 3520 positioned therein. The implantable cartridge body 3510 can comprise a first inner layer 3512, a second inner layer 3513, and an outer layer 3511. In at least one embodiment, the first inner layer 3512 can comprise a first thickness and the second inner layer 3513 can comprise a second thickness wherein the second inner layer 3513 can be thicker than the first inner layer 3512. In at least one alternative embodiment, the first inner layer 3512 can be thicker than the second inner layer 3513. In another alternative embodiment, the first inner layer 3512 can have the same, or at least substantially the same, thickness as the second inner layer 3513. In certain embodiments, each staple 3520 can comprise a base 3522 and one or more deformable legs 3521 extending from the base 3522. In various embodiments, each leg 3521 can comprise a tip 3523 which is embedded in the first inner layer 3511 and, in addition, each base 3522 of the staples 3520 can be embedded in the second inner layer 3512. In at least one embodiment, the first inner layer 3512 and/or the second inner layer 3513 can comprise at least one medicament stored therein and, in various embodiments, the outer layer 3511 can encapsulate and seal the first inner layer 3512 and the second inner layer 3513 such that the medicament does not flow out of the staple cartridge body 3510 until after the outer layer 3511 has been punctured by the staples 3520. More particularly, further to the above, an anvil can be pushed downwardly against tissue positioned against the tissue-contacting surface 3519 of staple cartridge 3500 such that the cartridge body 3510 is compressed and the surface 3519 is moved downwardly toward, and at least partially below, the staple tips 3523 such that the tips 3523 rupture or puncture the outer layer 3511. After the outer layer 3511 has been breached by the staple legs 3521, the at least one medicament M can flow out of the cartridge body 3510 around the staple legs 3521. In various circumstances, additional compression of the cartridge body 3510 can squeeze additional medicament M out of the cartridge body 3510 as illustrated in FIG. 126.

In various embodiments, referring again to FIG. 125, the outer layer 3511 can comprise a water impermeable, or at least substantially impermeable, wrap which can configured to, one, keep the medicament from prematurely flowing out of the staple cartridge 3500 and, two, prevent fluids within a surgical site, for example, from prematurely entering into the staple cartridge 3500. In certain embodiments, the first inner layer 3512 can comprise a first medicament stored, or absorbed, therein and the second inner layer 3513 can comprise a second medicament stored, or absorbed, therein, wherein the second medicament can be different than the first medicament. In at least one embodiment, an initial compression of the cartridge body 3510, which causes the rupture of the outer layer 3511, can generally express the first medicament out of the first inner layer 3512 and a subsequent compression of the cartridge body 3510 can generally express the second medicament out of the second inner layer 3513. In such embodiments, however, portions of the first medicament and the second medicament may be expressed simultaneously although a majority of the medicament that is initially expressed can be comprised of the first medicament and a majority of the medicament subsequently expressed thereafter can be comprised of the second medicament. In certain embodiments, further to the above, the first inner layer 3512 can be comprised of a more compressible material than the second inner layer 3513 such that the initial compression forces or pressure, which can be lower than the subsequent compression forces or pressure, can cause a larger initial deflection within the first inner layer 3512 than the second inner layer 3513. This larger initial deflection within the first inner layer 3512 can cause a larger portion of the first medicament to be expressed from the first inner layer 3512 than the second medicament from the second inner layer 3513. In at least one embodiment, the first inner layer 3512 can be more porous and/or more flexible than the second inner layer 3513. In at least one such embodiment, the first inner layer 3512 can comprise a plurality of pores, or voids, 3508 defined therein and the second inner layer 3513 can comprise a plurality of pores, or voids, 3509 defined therein wherein, in various embodiments, the pores 3508 can be configured to store the first medicament in the first inner layer 3512 and the pores 3509 can be configured to store the second medicament in the second inner layer 3513. In certain embodiments, the size and density of the pores 3508 within the first inner layer 3512 and the pores 3509 within the second inner layer 3513 can be selected so as to provide a desired result described herein.

In various embodiments, referring again to FIGS. 125 and 126, the outer layer 3511, the first inner layer 3512, and/or the second inner layer 3513 can be comprised of a bioabsorbable material. In at least one embodiment, the first inner layer 3512 can be comprised of a first bioabsorbable material, the second inner layer 3513 can be comprised of a second bioabsorbable material, and the outer layer 3511 can be comprised of a third bioabsorbable material, wherein the first bioabsorbable material, the second bioabsorbable material, and/or the third bioabsorbable material can be comprised of different materials. In certain embodiments, the first bioabsorbable material can be bioabsorbed at a first rate, the second bioabsorbable material can be bioabsorbed at a second rate, and the third bioabsorbable material can be bioabsorbed at a third rate, wherein the first rate, the second rate, and/or the third rate can be different. In at least one such embodiment, when a material is bioabsorbed at a particular rate, such a rate can be defined as the amount of material mass that is absorbed by a patient's body over a unit of time. As it is known, the bodies of different patients may absorb different materials at different rates and, thus, such rates may be expressed as average rates in order to account for such variability. In any event, a faster rate may be a rate in which more mass is bioabsorbed for a unit of time than a slower rate. In various embodiments, referring again to FIGS. 125 and 126, the first inner layer 3512 and/or the second inner layer 3513 can be comprised of a material which bioabsorbs faster than the material comprising the outer layer 3511. In at least one such embodiment, the first inner layer 3512 and/or the second inner layer 3513 can be comprised of a bioabsorbable foam, tissue sealant, and/or hemostatic material, such as oxidized regenerated cellulose (ORC), for example, and the outer layer 3511 can be comprised of a buttress material and/or plastic material, such as polyglycolic acid (PGA) which is marketed under the trade name Vicryl, polylactic acid (PLA or PLLA), polydioxanone (PDS), polyhydroxyalkanoate (PHA), poliglecaprone 25 (PGCL) which is marketed under the trade name Monocryl, polycaprolactone (PCL), and/or a composite of PGA, PLA, PDS, PHA, PGCL and/or PCL, for example. In such embodiments, the first inner layer 3512 and/or the second inner layer 3513 can immediately treat the tissue and can reduce bleeding from the tissue, for example, wherein the outer layer 3514 can provide longer-term structural support and can be bioabsorbed at a slower rate.

Owing to the slower rate of bioabsorbability of the outer layer 3511, further to the above, the outer layer 3511 can buttress or structurally reinforce the tissue within the staple line as it heals. In certain embodiments, one of the first inner layer 3512 and the second inner layer 3513 can be comprised of a material which can be bioabsorbed faster than the other such that, in at least one embodiment, one of the layers can provide an initial release of a therapeutic material and the other layer can provide a sustained release of the same therapeutic material and/or a different therapeutic material. In at least one such embodiment, the rate in which a therapeutic material can be released from a layer 3512, 3513 can be a function of the bioabsorbability of the substrate layer in which the medicament is absorbed or dispersed. For example, in at least one embodiment, the substrate comprising the first inner layer 3512 can be bioabsorbed faster than the substrate comprising the second inner layer 3513 and, as a result, a medicament can be release from the first inner layer 3512 faster than the second inner layer 3513, for example. In various embodiments, as described herein, one or more of the layers 3511, 3512, and 3513 of the cartridge body 3510 can be adhered to one another by at least one adhesive, such as fibrin and/or protein hydrogel, for example. In certain embodiments, the adhesive can be water soluble and can be configured to release the connection between the layers as the staple cartridge 3500 is being implanted and/or some time thereafter. In at least one such embodiment, the adhesive can be configured to bioabsorb faster than the outer layer 3511, the first inner layer 3512, and/or the second inner layer 3513.

In various embodiments, referring now to FIGS. 127 and 128, a staple cartridge, such as staple cartridge 3600, for example, can comprise a cartridge body 3610 including a compressible first layer 3611, a second layer 3612 attached to the first layer 3611, and a removable compressible layer 3613 attached to the second layer 3612. In at least one such embodiment, the first layer 3611 can be comprised of a compressible foam material, the second layer 3612 can comprise a laminate material adhered to the first layer 3611 utilizing one or more adhesives, and the third layer 3613 can comprise a compressible foam material removably adhered to the second layer 3612 utilizing one or more adhesives, for example. In various embodiments, the staple cartridge 3600 can further comprise a plurality of staples, such as staples 3620, for example, positioned in the cartridge body 3610. In at least one such embodiment, each staple 3620 can comprise a base 3622 positioned in the third layer 3613 and one or more deformable legs 3621 extending upwardly from the base 3622 through the second layer 3612 and into the first layer 3611, for example. In use, further to the above, the top surface 3619 of the staple cartridge body 3610 can be pushed downwardly by an anvil until the staple legs 3621 penetrate through the top surface 3619 and the targeted tissue and contact the anvil. After the staple legs 3621 have been sufficiently deformed, the anvil can be moved away from the staple cartridge 3600 such that the compressible layers thereof can at least partially re-expand. In various circumstances, the insertion of the staples through the tissue can cause the tissue to bleed. In at least one embodiment, the third layer 3613 can be comprised of an absorbent material, such as protein hydrogel, for example, which can draw blood away from the stapled tissue. In addition to or in lieu of the above, the third layer 3613 can be comprised of a hemostatic material and/or tissue sealant, such as freeze-dried thrombin and/or fibrin, for example, which can be configured to reduce the bleeding from the tissue. In certain embodiments, the third layer 3613 may provide a structural support to the first layer 3611 and the second layer 3612 wherein the third layer 3613 may be comprised of a bioabsorbable material and/or a non-bioabsorbable material. In any event, in various embodiments, the third layer 3613 can be detached from the second layer 3612 after the staple cartridge 3610 has been implanted. In embodiments where the third layer 3613 comprises an implantable-quality material, the surgeon can elect whether to remove the third layer 3613 of the cartridge body 3610. In at least one embodiment, the third layer 3613 can be configured to be removed from the second layer 3612 in one piece.

In various embodiments, the first layer 3611 can be comprised of a first foam material and the third layer 3613 can be comprised of a second foam material which can be different than the first foam material. In at least one embodiment, the first foam material can have a first density and the second foam material can have a second density wherein the first density can be different than the second density. In at least one such embodiment, the second density can be higher than the first density wherein, as a result, the third layer 3613 may be less compressible, or have a lower compression rate, than the first layer 3611. In at least one alternative embodiment, the first density can be higher than the second density wherein, as a result, the first layer 3611 may be less compressible, or have a lower compression rate, than the third layer 3613. In various embodiments, referring now to FIGS. 129 and 130, a staple cartridge 3700, similar to the staple cartridge 3600, can comprise a cartridge body 3710 comprising a first compressible foam layer 3711, a second layer 3712 attached to the first layer 3711, and a detachable third compressible foam layer 3713 removably attached to the second layer 3712. In at least one such embodiment, the third layer 3713 can comprise a plurality of staple receiving slots, or cut-outs, 3709 which can each be configured to receive at least a portion of a staple 3620, such as a staple base 3622, for example, therein. In certain embodiments, the staples 3620 can be configured to slide within the staple receiving slots 3709 or, stated another way, the third layer 3713 can be configured to slide relative to the staples 3620 when the staple cartridge 3700 is positioned against the targeted tissue and compressed by an anvil, for example. In at least one embodiment, the receiving slots 3709 can be configured such that there is clearance between the staples 3620 and the side walls of the receiving slots 3709. In at least one such embodiment, as a result of the above, the staples 3620 may not capture a portion of the third layer 3713 therein when the staples 3620 are deformed, as illustrated in FIGS. 129 and 130. In certain other embodiments, the ends of the staple receiving slots 3709 adjacent to the second layer 3712 can be closed by a portion of the third layer 3713 and, as a result, at least a portion of the third layer 3713 can be captured within the staples 3620 when they are deformed. In any event, the third layer 3713 can comprise one or more perforations and/or score marks 3708, for example, which can be configured to permit the third layer 3713 to be removed from the second layer 3712 in two or more pieces as illustrated in FIG. 129. In FIG. 129, one of the pieces of the third layer 3713 is illustrated as being removed by a tool 3755. In various embodiments, the perforations 3708 can be arranged along a line positioned intermediate a first row of staples and a second row of staples.

In various embodiments, referring again to FIGS. 129 and 130, the bases 3622 of the staples 3620 can be positioned within the receiving slots 3709 wherein, in at least one embodiment, the side walls of the receiving slots 3709 can be configured to contact and releasable retain the staple legs 3621 in position. In certain embodiments, although not illustrated, the third layer 3713 can comprise an elongated slot surrounding all of the staples within a staple line. In at least one such embodiment, a staple cartridge comprising four staple rows, for example, can comprise an elongate slot aligned with each staple row in the bottom layer of the staple cartridge. Further to the above, at least a portion of the staple cartridge 3600 and/or the staple cartridge 3700 can be implanted within a patient and at least a portion of the staple cartridge can be removable from the patient. In at least one embodiment, referring again to FIGS. 129 and 130, the first layer 3711 and the second layer 3712 can be captured within the staples 3620 and can be implanted with the staples 3620, whereas the third layer 3713 can be optionally removed or detached from the staple cartridge 3700. In various circumstances, the removal of a portion of the implanted staple cartridge can reduce the amount of material that the patient's body has to reabsorb which can provide various therapeutic benefits. In the event that a portion of a staple cartridge is detached and removed, such as by a laparoscopic tool 3755, for example, the detached staple cartridge portion can be removed from the surgical site through a trocar, such as a trocar having a 5 mm aperture, for example. In certain embodiments, a cartridge body can comprise more than one layer that can be removed. For example, the cartridge body 3710 can comprise a fourth layer wherein the third layer of 3713 of the cartridge body 3710 can be comprised of a hemostatic material and the fourth layer can be comprised of a support layer. In at least one such embodiment, a surgeon can remove the support layer and then elect whether to remove the hemostatic layer, for example.

In various embodiments, referring now to FIG. 131, a staple cartridge, such as staple cartridge 3800, for example, can comprise a cartridge body 3810 including an outer layer 3811 and an inner layer 3812. The inner layer 3812 can be comprised of a compressible foam material and the outer layer 3811 can be at leas partially wrapped around the inner layer 3812. In at least one embodiment, the outer layer 3811 can comprise a first portion 3811a configured to be positioned on a first side of the inner layer 3812 and a second portion 3811b configured to be positioned on a second side of the inner layer 3812 wherein the first portion 3811a and the second portion 3811b can be connected by a flexible hinge, such as hinge 3809, for example. In at least one such embodiment, at least one adhesive, such as fibrin and/or protein hydrogel, for example, can be applied to the first side and/or the second side of the inner layer 3812 in order to secure the portions of the outer layer 3811 thereto. In various embodiments, the outer layer 3811 can comprise one or more fastening members extending therefrom. In at least one such embodiment, the outer layer 3811 can comprise a plurality of deformable legs 3821 extending from one side of the outer layer 3811 which can be seated in the compressible inner layer 3812. In at least one such embodiment, the legs 3821 may not protrude from the second side of the inner layer 3812 while, in at least one alternative embodiment, the legs 3821 may at least partially protrude from the inner layer 3812. When the compressible cartridge body 3810 is compressed, in use, the legs 3821 can be configured to pierce the inner layer 3812 and the second portion 3811b of the outer layer 3811. In certain embodiments, the second portion 3811b of the outer layer 3811 can comprise apertures, such as apertures 3808, for example defined therein which can be configured to receive the staple legs 3821. In certain embodiments, at least portions of the staple cartridge 3800 can comprise a knife slot 3803 which can be configured to slidably receive a cutting member therein. In at least one such embodiment, the knife slot 3803 may not extend entirely through the thickness of the cartridge body 3810 and, as a result, the cutting member may incise the cartridge body 3810 as it is moved relative thereto.

In various embodiments, referring now to FIG. 132, a staple cartridge 3900 can comprise, similar to staple cartridge 3800, a cartridge body 3910 including an inner layer 3812 and an outer layer 3811, wherein the outer layer 3811 can comprise a first portion 3811a positioned adjacent to the first side of the inner layer 3812 and a second portion 3811b positioned adjacent to the second side of the inner layer 3812. In at least one embodiment, similar to the above, the outer layer 3811 can comprise one or more fastening members extending therefrom. In at least one such embodiment, the outer layer 3811 can comprise a plurality of deformable legs 3921 extending from one side of the outer layer 3811 which can be seated in the compressible inner layer 3812. In certain embodiments, each deformable leg 3921 can comprise at least one hook or barb 3923 protruding therefrom which can be configured to engage the second portion 3811b of the outer layer 3811 and, as a result, retain the outer layer 3811 to the inner layer 3812. In at least one such embodiment, the barbs 3923 can be configured to protrude from the second side of the inner layer 3812 and extend through the apertures 3808 in the second portion 3811b of the outer layer 3811 such that the barbs 3923 can engage the outside surface of the outer layer 3811 and lock the outer layer 3811 to the inner layer 3812. In order to construct the staple cartridge 3900, the inner layer 3812 may be at least partially compressed in order to cause the barbs to protrude therefrom and enter into the apertures 3808. In at least one such embodiment, the staple cartridge 3900 can be at least partially pre-compressed when it is inserted into a staple cartridge, for example. In certain embodiments, further to the above, at least a portion of the legs 3921 can be embedded within the first portion 3811a of the outer layer 3811 wherein, in at least one embodiment, the outer layer 3811 can be comprised of a plastic material, such as polydioxanone (PDS) and/or polyglycolic acid (PGA), for example, and the plastic material can be overmolded around at least a portion of the legs 3921.

In various embodiments, referring now to FIGS. 133-137, a staple cartridge, such as staple cartridge 4000, for example, can comprise a cartridge body 4010 including a compressible first layer 4011 and a second layer 4012 and, in addition, a plurality of staples 4020 positioned within the cartridge body 4010. In certain embodiments, referring to FIG. 135, each staple 4020 can comprise a base 4022 and at least one deformable leg 4023 extending from the base 4022. In at least one embodiment, referring to FIG. 133, the staple cartridge 4000 can be positioned between a staple cartridge channel 4030 and an anvil 4040 of an end effector of a surgical stapler wherein the second layer 4012 of the cartridge body 4010 and/or the bases 4022 of the staples 4020 can be positioned against the staple cartridge channel 4030. In various embodiments, referring now to FIG. 134, the second layer 4012 can comprise a layer of pledgets 4060 interconnected to one another by a pledget support frame 4061. In at least one such embodiment, the pledgets 4060 and the pledget support frame 4061 can be comprised of a molded plastic material, such as polyglycolic acid (PGA), for example. Each pledget 4060 can comprise one or more apertures or slots 4062 which can be configured to receive a staple leg 4021 extending therethrough as illustrated in FIGS. 135 and 136. Each pledget 4060 can further comprise a receiving slot 4063 defined therein which can be configured to receive a base 4022 of a staple 4020. In various embodiments, referring again to FIG. 134, the pledgets 4060 and/or pledget support fame 4061 can comprise a plurality of score marks, perforations, or the like which can be configured to allow the pledgets 4060 to become detached from the pledget support frame 4061 at a desired location. Similarly, referring to FIG. 136, one or more pledgets 4060 can be connected to one another along a line comprising perforations and/or score marks 4064, for example. In use, the compressible foam layer 4011 can be positioned against the targeted tissue T and the cartridge body 4010 can be compressed by the anvil 4040 such that the anvil 4040 can deform the staples 4020. When the staples 4020 are deformed, the staple legs 4021 of each staple 4020 can capture the tissue T, a portion of the first layer 4011, and a pledget 4060 within the deformed staple. When the staple cartridge channel 4030 is moved away from the implanted staple cartridge 4060, for example, the pledget support frame 4061 can be detached from the pledgets 4060 and/or the pledgets 4060 can be detached from one another. In certain circumstances, the pledgets 4060 can be detached from the frame 4061 and/or each other when the staples 4020 are being deformed by the anvil 4040 as described above.

In various embodiments described herein, the staples of a staple cartridge can be fully formed by an anvil when the anvil is moved into a closed position. In various other embodiments, referring now to FIGS. 138-141, the staples of a staple cartridge, such as staple cartridge 4100, for example, can be deformed by an anvil when the anvil is moved into a closed position and, in addition, by a staple driver system which moves the staples toward the closed anvil. The staple cartridge 4100 can comprise a compressible cartridge body 4110 which can be comprised of a foam material, for example, and a plurality of staples 4120 at least partially positioned within the compressible cartridge body 4110. In various embodiments, the staple driver system can comprise a driver holder 4160, a plurality of staple drivers 4162 positioned within the driver holder 4160, and a staple cartridge pan 4180 which can be configured to retain the staple drivers 4162 in the driver holder 4160. In at least one such embodiment, the staple drivers 4162 can be positioned within one or more slots 4163 in the driver holder 4160 wherein the sidewalls of the slots 4163 can assist in guiding the staple drivers 4162 upwardly toward the anvil. In various embodiments, the staples 4120 can be supported within the slots 4163 by the staple drivers 4162 wherein, in at least one embodiment, the staples 4120 can be entirely positioned in the slots 4163 when the staples 4120 and the staple drivers 4162 are in their unfired positions. In certain other embodiments, at least a portion of the staples 4120 can extend upwardly through the open ends 4161 of slots 4163 when the staples 4120 and staple drivers 4162 are in their unfired positions. In at least one such embodiment, referring primarily now to FIG. 139, the bases of the staples 4120 can be positioned within the driver holder 4160 and the tips of the staples 4120 can be embedded within the compressible cartridge body 4110. In certain embodiments, approximately one-third of the height of the staples 4120 can be positioned within the driver holder 4160 and approximately two-thirds of the height of the staples 4120 can be positioned within the cartridge body 4110. In at least one embodiment, referring to FIG. 138A, the staple cartridge 4100 can further comprise a water impermeable wrap or membrane 4111 surrounding the cartridge body 4110 and the driver holder 4160, for example.

In use, the staple cartridge 4100 can be positioned within a staple cartridge channel, for example, and the anvil can be moved toward the staple cartridge 4100 into a closed position. In various embodiments, the anvil can contact and compress the compressible cartridge body 4110 when the anvil is moved into its closed position. In certain embodiments, the anvil may not contact the staples 4120 when the anvil is in its closed position. In certain other embodiments, the anvil may contact the legs of the staples 4120 and at least partially deform the staples 4120 when the anvil is moved into its closed position. In either event, the staple cartridge 4100 can further comprise one or more sleds 4170 which can be advanced longitudinally within the staple cartridge 4100 such that the sleds 4170 can sequentially engage the staple drivers 4162 and move the staple drivers 4162 and the staples 4120 toward the anvil. In various embodiments, the sleds 4170 can slide between the staple cartridge pan 4180 and the staple drivers 4162. In embodiments where the closure of the anvil has started the forming process of the staples 4120, the upward movement of the staples 4120 toward the anvil can complete the forming process and deform the staples 4120 to their fully formed, or at least desired, height. In embodiments where the closure of the anvil has not deformed the staples 4120, the upward movement of the staples 4120 toward the anvil can initiate and complete the forming process and deform the staples 4120 to their fully formed, or at least desired, height. In various embodiments, the sleds 4170 can be advanced from a proximal end of the staple cartridge 4100 to a distal end of the staple cartridge 4100 such that the staples 4120 positioned in the proximal end of the staple cartridge 4100 are fully formed before the staples 4120 positioned in the distal end of the staple cartridge 4100 are fully formed. In at least one embodiment, referring to FIG. 140, the sleds 4170 can each comprise at least one angled or inclined surface 4711 which can be configured to slide underneath the staple drivers 4162 and lift the staple drivers 4162 as illustrated in FIG. 141.

In various embodiments, further to the above, the staples 4120 can be formed in order to capture at least a portion of the tissue T and at least a portion of the compressible cartridge body 4110 of the staple cartridge 4100 therein. After the staples 4120 have been formed, the anvil and the staple cartridge channel 4130 of the surgical stapler can be moved away from the implanted staple cartridge 4100. In various circumstances, the cartridge pan 4180 can be fixedly engaged with the staple cartridge channel 4130 wherein, as a result, the cartridge pan 4180 can become detached from the compressible cartridge body 4110 as the staple cartridge channel 4130 is pulled away from the implanted cartridge body 4110. In various embodiments, referring again to FIG. 138, the cartridge pan 4180 can comprise opposing side walls 4181 between which the cartridge body 4110 can be removably positioned. In at least one such embodiment, the compressible cartridge body 4110 can be compressed between the side walls 4181 such that the cartridge body 4110 can be removably retained therebetween during use and releasably disengaged from the cartridge pan 4180 as the cartridge pan 4180 is pulled away. In at least one such embodiment, the driver holder 4160 can be connected to the cartridge pan 4180 such that the driver holder 4160, the drivers 4162, and/or the sleds 4170 can remain in the cartridge pan 4180 when the cartridge pan 4180 is removed from the surgical site. In certain other embodiments, the drivers 4162 can be ejected from the driver holder 4160 and left within the surgical site. In at least one such embodiment, the drivers 4162 can be comprised of a bioabsorbable material, such as polyglycolic acid (PGA) which is marketed under the trade name Vicryl, polylactic acid (PLA or PLLA), polydioxanone (PDS), polyhydroxyalkanoate (PHA), poliglecaprone 25 (PGCL) which is marketed under the trade name Monocryl, polycaprolactone (PCL), and/or a composite of PGA, PLA, PDS, PHA, PGCL and/or PCL, for example. In various embodiments, the drivers 4162 can be attached to the staples 4120 such that the drivers 4162 are deployed with the staples 4120. In at least one such embodiment, each driver 4162 can comprise a trough configured to receive the bases of the staples 4120, for example, wherein, in at least one embodiment, the troughs can be configured to receive the staple bases in a press-fit and/or snap-fit manner.

In certain embodiments, further to the above, the driver holder 4160 and/or the sleds 4170 can be ejected from the cartridge pan 4180. In at least one such embodiment, the sleds 4170 can slide between the cartridge pan 4180 and the driver holder 4160 such that, as the sleds 4170 are advanced in order to drive the staple drivers 4162 and staples 4120 upwardly, the sleds 4170 can move the driver holder 4160 upwardly out of the cartridge pan 4180 as well. In at least one such embodiment, the driver holder 4160 and/or the sleds 4170 can be comprised of a bioabsorbable material, such as polyglycolic acid (PGA) which is marketed under the trade name Vicryl, polylactic acid (PLA or PLLA), polydioxanone (PDS), polyhydroxyalkanoate (PHA), poliglecaprone 25 (PGCL) which is marketed under the trade name Monocryl, polycaprolactone (PCL), and/or a composite of PGA, PLA, PDS, PHA, PGCL and/or PCL, for example. In various embodiments, the sleds 4170 can be integrally formed and/or attached to a drive bar, or cutting member, which pushes the sleds 4170 through the staple cartridge 4100. In such embodiments, the sleds 4170 may not be ejected from the cartridge pan 4180 and may remain with the surgical stapler while, in other embodiments in which the sleds 4170 are not attached to the drive bar, the sleds 4170 may be left in the surgical site. In any event, further to the above, the compressibility of the cartridge body 4110 can allow thicker staple cartridges to be used within an end effector of a surgical stapler as the cartridge body 4110 can compress, or shrink, when the anvil of the stapler is closed. In certain embodiments, as a result of the staples being at least partially deformed upon the closure of the anvil, taller staples, such as staples having an approximately 0.18″ staple height, for example, could be used, wherein approximately 0.12″ of the staple height can be positioned within the compressible layer 4110 and wherein the compressible layer 4110 can have an uncompressed height of approximately 0.14″, for example.

In various embodiments, referring now to FIGS. 142-145, a staple cartridge, such as staple cartridge 4200, for example, can comprise a compressible cartridge body 4210, a plurality of staples 4220 positioned therein, and a plurality of flexible lateral support members 4234. In various embodiments, referring now to FIG. 143, the staple cartridge 4200 can be positioned intermediate an anvil 4240 and a staple cartridge channel 4230 wherein, in at least one embodiment, the lateral support members 4234 can be attached to the staple cartridge channel 4230. When the anvil 4240 is moved downwardly to compress the cartridge body 4210 and at least partially deform the staples 4220, as illustrated in FIG. 144, the side portions of the cartridge body 4210 can bulge laterally and push the lateral support members 4234 outwardly. In at least one such embodiment, the lateral support members 4234 can be attached to the cartridge body 4210 and, when the cartridge body 4210 bulges laterally as described above, the lateral support members 4234 can detach from the cartridge body 4210 as illustrated in FIG. 144. In at least one embodiment, the lateral support members 4234 can be adhered to the cartridge body 4210 utilizing at least one adhesive, such as fibrin and/or protein hydrogel, for example Similar to the above, the closing of the anvil 4240 may only partially deform the staples 4220, wherein the formation of the staples 4220 can be completed by the advancement of one or more sleds 4270 through the staple cartridge 4200 as illustrated in FIG. 145. In various embodiments, referring now to FIGS. 147 and 148, the sleds 4270 can be advanced from a proximal end of the staple cartridge 4200 to a distal end of the staple cartridge 4200 by a cutting member 4280. In at least one such embodiment, the cutting member 4280 can comprise a cutting element, or knife, 4283, which can be advanced through the tissue T and/or the compressible cartridge body 4210. In certain embodiments, the cutting member 4280 can comprise camming members 4282 which can travel along the outside surfaces of the jaws 4230 and 4240 and move or hold the jaws in position. In various embodiments, as a result of the above, the staples 4220 can be formed into their final shapes at the same time, or at least substantially the same time, as the tissue T is incised. In at least one such embodiment, the sleds 4270 can be positioned distally with respect to the knife 4283 such that the tissue T is only incised when the proceeding portion of the tissue has been fully stapled, for example.

In various embodiments, referring again to FIGS. 147 and 148, the sleds 4270 can comprise separate slidable members which are advanced together by the cutting member 4280. In at least one such embodiment, the sleds 4270 can be contained within the staple cartridge 4200 and the cutting member 4280 can be advanced into the staple cartridge 4200 by a firing bar 4281 such that the cutting member 4280 engages the sleds 4270 and advances the sleds 4270 distally. In certain embodiments, the sleds 4270 can be connected to one another. In either event, each sled 4270 can comprise an angled surface, or cam, 4271 which can be configured to lift the staples 4220 aligned within a staple row. In certain embodiments, the angled surfaces 4271 can be integrally formed with the cutting member 4280. In at least one embodiment, referring again to FIGS. 147 and 148, each staple 4200 can comprise a base, at least one deformable member extending from the base, and a crown 4229 overmolded onto and/or positioned around at least a portion of the base and/or the deformable members of the staple 4200. In various embodiments, such crowns 4229 can be configured to be driven directly by a sled 4270, for example. More particularly, in at least one embodiment, the crowns 4229 of staples 4220 can be configured such that the angled surfaces 4271 of the sleds 4270 can slide underneath and directly contact the crowns 4229 without a staple driver positioned therebetween. In such embodiments, each crown 4229 can comprise at least one co-operating angled or inclined surface which can be engaged by an angled surface 4271 of the sleds 4270 such that the co-operating angled surfaces can drive the staples 4220 upwardly when the sleds 4270 are slid underneath the staples 4220.

In various embodiments, referring now to FIG. 146, a staple cartridge, such as staple cartridge 4300, for example, can comprise a compressible body 4310 and a plurality of staples 4320 positioned within the compressible body 4310. Similar to the above, the staple cartridge 4300 can comprise flexible lateral supports 4334 which can be attached to a staple cartridge channel and/or adhered to the compressible body 4310. In addition to the above, the flexible lateral supports 4334 can be connected together by one or more struts, or connection members, 4335 which can be configured to hold the lateral supports 4334 together. In use, the connection members 4335 can be configured to prevent, or at least inhibit, the lateral supports 4334 from becoming prematurely detached from the cartridge body 4310. In certain embodiments, the connection members 4335 can be configured to hold the lateral supports 4334 together after the staple cartridge 4300 has been compressed by an anvil. In such embodiments, the lateral supports 4334 can resist the lateral bulging, or displacement, of the lateral portions of the cartridge body 4310. In certain embodiments, a cutting member, such as cutting member 4280, for example, can be configured to transect the connection members 4335 as the cutting member 4280 is moved distally within the cartridge body 4310. In at least one such embodiment, the cutting member 4280 can be configured to push one or more sleds, such as sleds 4270, for example, distally in order to form the staples 4320 against an anvil. The sleds 4270 can lead the cutting edge 4283 such that the cutting member 4280 does not transect a connection member 4335 until the staples 4320 adjacent to that connection member 4335 have been fully formed, or at least formed to a desired height. In various circumstances, the connection members 4335, in co-operation with the lateral supports 4334, can prevent, or at least reduce, the lateral movement of the compressible cartridge body 4310 and, concurrently, prevent, or at least reduce, the lateral movement of the staples 4320 positioned within the cartridge body 4310. In such circumstances, the connection members 4335 can hold the staples 4320 in position until after they are deformed and the connection members 4335 can be thereafter cut to release the lateral portions of the cartridge body 4310. As mentioned above, the lateral supports 4334 can be connected to the staple cartridge channel and, as a result, can be removed from the surgical site with the staple cartridge channel after the staple cartridge 4300 has been implanted. In certain embodiments, the lateral supports 4334 can be comprised of an implantable material and can be left within a surgical site. In at least one embodiment, the connection members 4335 can be positioned intermediate the cartridge body 4310 and the tissue T and, after the connection members 4335 have been detached from the lateral supports 4334, the connections members 4335 can remain implanted in the patient. In at least one such embodiment, the connection members 4335 can be comprised of an implantable material and, in certain embodiments, the connection members 4335 can be comprised of the same material as the lateral supports 4334, for example. In various embodiments, the connection members 4335 and/or lateral supports 4334 can be comprised of a flexible bioabsorbable material such as polyglycolic acid (PGA) which is marketed under the trade name Vicryl, polylactic acid (PLA or PLLA), polydioxanone (PDS), polyhydroxyalkanoate (PHA), poliglecaprone 25 (PGCL) which is marketed under the trade name Monocryl, polycaprolactone (PCL), and/or a composite of PGA, PLA, PDS, PHA, PGCL and/or PCL, for example. In various embodiments, a connection member can comprise a sheet of material connecting the lateral supports 4334. In certain embodiments, a staple cartridge can comprise connection members extending across the top surface of the cartridge body 4310 and, in addition, connection members extending around the bottom surface of the cartridge body 4310.

In various embodiments, referring now to FIG. 149, a staple cartridge can comprise staples, such as staples 4420, for example, which can comprise a wire portion inserted into a crown portion. In at least one embodiment, the wire portion can be comprised of metal, such as titanium and/or stainless steel, for example, and/or plastic, such as polydioxanone (PDS) and/or polyglycolic acid (PGA), for example. In at least one embodiment, the crown portion can be comprised of metal, such as titanium and/or stainless steel, for example, and/or plastic, such as polydioxanone (PDS) and/or polyglycolic acid (PGA), for example. In certain embodiments, the wire portion of each staple 4420 can comprise a base 4422 and deformable legs 4421 extending from the base 4422 wherein the crown portion of each staple 4420 can comprise a crown 4429 which can be configured to receive at least a portion of a base 4422 therein. In order to assemble the portions of each staple 4420, referring now to FIGS. 150A-150C, the legs 4421 of the wire portion can be inserted into an opening 4426 in a crown 4429 wherein the opening 4426 can be configured to guide the legs 4421 into a base chamber 4427. The wire portion can be further inserted into the crown 4429 such that the legs 4421 exit the base chamber 4427 and the base 4422 of the wire portion enters into the base chamber 4427. In at least one such embodiment, the base chamber 4427 can be configured such that the wire portion is rotated within the crown 4429 as the base 4422 enters into the base chamber 4427 such that the staple legs 4421 are pointed in an upward, or at least substantially upward, direction. In various embodiments, referring again to FIG. 149, the crown 4429 can comprise exit holes 4425 which can be configured to receive the staple legs 4421 therein.

In various embodiments, further to the above, a surgical stapler can comprise a sled 4470 configured to transverse the staple cartridge 4400 and staple cartridge channel 4430 and move the staples 4420 contained within the cartridge body 4410 toward an anvil. In various circumstances, the sled 4470 can be moved from a proximal end of the staple cartridge channel 4430 to a distal end of the cartridge channel 4430 in order to implant the cartridge body 4410 and the staples 4420. In certain circumstances, the sled 4470 can be retracted or returned to the proximal end of the cartridge channel 4430 and another staple cartridge 4400 can be inserted into the cartridge channel 4430. Once the new staple cartridge 4400 has been positioned within the cartridge channel 4430, the sled 4470 can be advanced distally once again. In various embodiments, the surgical stapler may comprise one or more lock-out features which can prevent the sled 4470 from being advanced distally once again without a new staple cartridge 4400 being positioned within the cartridge channel 4430. In at least one such embodiment, referring again to FIG. 149, the staple cartridge channel 4430 can comprise a lock-out shoulder 4439 which can be configured to prevent, or at least limit, the distal movement of the sled 4470. More particularly, the sled 4470 can be configured to abut the shoulder 4439 unless the sled 4470 is at least partially lifted upwardly over the shoulder 4439 by a lift feature 4428, for example, extending between the proximal-most staples 4420 within a staple cartridge 4400. Stated another way, absent the presence of the proximal-most staples 4420 in a new staple cartridge 4400, the sled 4470 cannot be advanced. Thus, when an expended staple cartridge 4400 is present within the cartridge channel 4430, or no staple cartridge 4400 is present in the cartridge channel 4430 at all, the sled 4470 cannot be advanced within the cartridge channel 4430.

Further to the above, referring now to FIG. 151, a staple cartridge, such as staple cartridge 4500, for example, can be positioned within a staple cartridge channel 4530 and can comprise a compressible cartridge body 4510, a plurality of staples 4520 positioned within the cartridge body 4510, and a cartridge pan, or retainer, 4580. In various embodiments, the compressible cartridge body 4510 can comprise an outer layer 4511 and an inner layer 4512 wherein, in at least one embodiment, the outer layer 4511 can sealingly enclose the inner layer 4512. In at least one such embodiment, the outer layer 4511 can extend between the inner layer 4512 and the cartridge pan 4580. In certain other embodiments, the outer layer 4511 may only partially surround the inner layer 4512 and, in at least one such embodiment, the outer layer 4511 and the cartridge pan 4580 can co-operate to encompass, or at least substantially encompass, the inner layer 4512. In various embodiments, further to the above, the staples 4520 can be supported by the cartridge pan 4580 wherein the cartridge pan 4580 can comprise one or more staple support channels configured to support the staples 4520. In certain embodiments, the cartridge pan 4580 can be attached to the cartridge body 4510 wherein, in at least one such embodiment, the cartridge body 4510 can be compressed laterally between opposing side walls of the cartridge pan 4580. In various embodiments, the side walls of the cartridge pan 4580 can support the cartridge body 4510 laterally and, in at least one such embodiment, the cartridge pan 4580 can comprise one or more walls, or fins, 4582 extending upwardly from the bottom support 4583 into the cartridge body 4510. In at least one such embodiment, the cartridge body 4510 can comprise one or more slots, or channels, therein which can be configured to receive and/or interlock with the walls 4582. In various embodiments, the walls 4582 can extend partially, or almost entirely, through the cartridge body 4510. In at least one such embodiment, the walls 4582 can extend longitudinally through the staple cartridge 4500 between a first row of staples 4520 and a second row of staples 4520.

In various embodiments, the cartridge body 4510 and/or the cartridge pan 4580 can comprise co-operating retention features which can provide a snap-fit between the cartridge pan 4580 and the cartridge body 4510. In certain embodiments, the staple cartridge 4500 can be positioned within the cartridge channel 4530 such that the cartridge pan 4580 is positioned against and/or attached to the cartridge channel 4530. In at least one embodiment, the cartridge pan 4580 can be detachably coupled to the cartridge channel 4530 such that, after the staple cartridge 4500 has been compressed by the anvil 4540 and the staples 4520 have been deformed, the cartridge pan 4580 can detach from the cartridge channel 4530 and can be implanted with the cartridge body 4510. In at least one such embodiment, the cartridge pan 4580 can be comprised of a bioabsorbable material such as polyglycolic acid (PGA) which is marketed under the trade name Vicryl, polylactic acid (PLA or PLLA), polydioxanone (PDS), polyhydroxyalkanoate (PHA), poliglecaprone 25 (PGCL) which is marketed under the trade name Monocryl, polycaprolactone (PCL), and/or a composite of PGA, PLA, PDS, PHA, PGCL and/or PCL, for example. In certain embodiments, a surgical stapler can further comprise a firing mechanism and/or driver which can be slid intermediate the staple cartridge channel 4530 and a bottom drive surface on the cartridge pan 4580 which can be configured to lift or eject the cartridge pan 4580 from the cartridge channel 4530. In certain embodiments, the cartridge body 4510 can be detachably coupled to the cartridge pan 4580 such that, after the staple cartridge 4500 has been compressed by the anvil 4540 and the staples 4520 have been deformed, the cartridge body 4510 can detach from the cartridge pan 4580. In at least one such embodiment, the cartridge pan 4580 can remain fixedly engaged with the cartridge channel 4530 such that the cartridge pan 4580 is removed from the surgical site with the cartridge channel 4530. In certain embodiments, a surgical stapler can further comprise a firing mechanism and/or driver which can be slid intermediate the staple cartridge pan 4580 and a bottom drive surface on the cartridge body 4510 which can be configured to lift or eject the cartridge body 4510 from the cartridge pan 4580. In at least one such embodiment, the staple cartridge 4500 can further comprise staple drivers positioned intermediate the cartridge pan 4580 and the staples 4520 such that, as the firing mechanism is slid distally, the staple drivers and the staples 4520 can be driven upwardly toward the anvil. In at least one such embodiment, the staple drivers can be at least partially embedded within the compressible cartridge body 4510.

In various embodiments, similar to the above, the staple cartridge 4500 can comprise a lock-out feature which can be configured to prevent, or at least limit, the distal movement of a cutting member unless a unfired staple cartridge 4500 has been positioned within the staple cartridge channel 4530. In certain embodiments, the staple cartridge pan 4580 can comprise a surface which lifts the cutting member upwardly and over a locking surface within the staple cartridge channel 4530, for example. In the event that a staple cartridge 4500 comprising a cartridge pan 4580 is not present in the cartridge channel 4530, the cutting member cannot be advanced. In at least one embodiment, the proximal-most staples, and/or any other suitable staples, within a staple cartridge 4500 can comprise a lifting surface which can sufficiently lift the cutting member over the locking surface. In addition to or in lieu of the above, various portions of the staple cartridge 4500 can be comprised of materials having different colors. In such embodiments, a surgeon may be able to visually identify when an unfired and/or fired staple cartridge is present in the staple cartridge channel 4530. In at least one such embodiment, the outer layer 4511 of the cartridge body 4510 may have a first color, the cartridge pan 4580 may have a second color, and the staple cartridge channel 4530 may have a third color. In the event that the surgeon sees the first color, the surgeon may know that an unfired cartridge 4500 is present in the staple cartridge channel 4530; in the event that the surgeon sees the second color, the surgeon may know that a fired cartridge 4500 is present in the staple cartridge channel 4530 and that the remaining cartridge pan 4580 needs to be removed; and in the event that the surgeon sees the third color, the surgeon may know that no portion of a staple cartridge 4500 remains within the cartridge channel 4530.

In various embodiments, referring now to FIG. 152, a staple cartridge, such as staple cartridge 4600, for example, can comprise a compressible, implantable cartridge body 4610 and a plurality of staples 4620 positioned therein. The cartridge body 4610 can comprise an outer layer 4611 and an inner layer 4612. In certain embodiments, the inner layer 4612 can comprise a plurality of pockets, such as pockets, or cavities, 4615, for example, defined therein which can facilitate the collapse of the cartridge body 4610. In at least one such embodiment, the inner layer 4612 can comprise a corrugated, or honeycomb-configured, lattice which can be configured to withstand a compressive force, or pressure, as long as the compressive force, or pressure, does not exceed a certain threshold value. When the threshold value has not been exceeded, the inner layer 4612 can deform at a linear, or at least substantially linear, rate with respect to the compressive force, or pressure, being applied. After the compressive force, or pressure, has exceeded the threshold value, the inner layer 4612 can suddenly succumb to large deflections and collapse, or buckle, as a result of the compressive load. In various embodiments, the lattice of the inner layer 4612 can be comprised of a plurality of sub-layers 4612a which can be connected together. In at least one embodiment, each sub-layer 4612a can comprise a plurality of alternating furrows and ridges, or waves, which can be aligned with the alternating furrows and ridges of an adjacent sub-layer 4612a. In at least one such embodiment, the furrows of a first sub-layer 4612a can be positioned adjacent to the ridges of a second sub-layer 4612a and, similarly, the ridges of the first sub-layer 4612a can be positioned adjacent to the furrows of the second sub-layer 4612a. In various embodiments, the adjacent sub-layers 4612a can be adhered to one another and/or the outer layer 4611 by at least one adhesive, such as fibrin and/or protein hydrogel, for example. FIG. 153 illustrates the staple cartridge 4600 after the cartridge body 4610 has been collapsed and the staples 4620 have been deformed in order to capture and hold tissue T against the cartridge body 4610.

In various embodiments, referring now to FIGS. 154-156, a staple cartridge, such as staple cartridge 4700, for example, can comprise a compressible, implantable cartridge body 4710 and a plurality of staples 4720 positioned within the cartridge body 4710. Similar to the above, the cartridge body 4710 can comprise an outer layer 4711 and an inner layer 4712, wherein the inner layer 4712 can comprise a plurality of sub-layers 4712a. Also similar to the above, each sub-layer 4712a can comprise alternating furrows 4717 and ridges 4718 which can be aligned with one another to define pockets, or cavities, 4715 therebetween. In at least one such embodiment, the furrows 4717 and/or the ridges 4718 can extend along axes which are parallel to one another and/or parallel to a longitudinal axis 4709. In various embodiments, the staples 4720 can be aligned in a plurality of staple rows which can extend along axes which are parallel to one another and/or parallel to the longitudinal axis 4709. In various alternative embodiments, referring again to FIGS. 152 and 153, the staples 4620 contained in the cartridge body 4600 can extend along axes which are traverse or perpendicular with respect to the axes defined by the furrows and ridges of the sub-layers 4612a. Referring again to FIGS. 154-156, the staples 4720 can extend through the furrows 4717 and the ridges 4718 wherein friction forces between the staples 4720 and the sub-layers 4712a can hold the staples 4720 within the cartridge body 4710. In certain embodiments, the plurality of sub-layers 4712a can be comprised of a buttress material and/or plastic material, such as polydioxanone (PDS) and/or polyglycolic acid (PGA), for example, which can be configured to hold the staples 4720 in an upright orientation, for example, and/or hold the staples 4720 in alignment with respect to each other as illustrated in FIGS. 154 and 155. FIG. 156 illustrates the staple cartridge 4700 after the cartridge body 4710 has been collapsed and the staples 4720 have been deformed in order to capture and hold tissue T against the cartridge body 4710.

In various embodiments, referring again to FIGS. 154-156, the cartridge body 4710 can resiliently or elastically collapse when it is compressed. In at least one such embodiment, the waves formed within each sub-layer 4712a by the furrows 4717 and the ridges 4718 can be flattened, or at least substantially flattened, when the cartridge body 4710 is compressed which can collapse, or at least substantially collapse, the cavities 4715 defined therebetween. In various circumstances, the cartridge body 4710, or at least portions of the cartridge body 4710, can resiliently or elastically re-expand after the compressive force, or pressure, has been removed from the cartridge body 4710. In at least one such embodiment, the connections between the furrows 4717 and the ridges 4718 of adjacent sub-layers 4712a can remain intact, or at least substantially intact, when the cartridge body 4710 is compressed such that, after the compression force has been removed from the cartridge body 4710, the sub-layers 4712a can bias themselves away from each other and, as a result, at least partially re-expand the cartridge body 4710. In certain embodiments, the cartridge body 4710 can be plastically deformed, or crushed, when it is compressed and, as a result, the cartridge body 4710 may not re-expand after the compressive force, or pressure, has been removed from the cartridge body 4710. In certain embodiments, referring now to FIG. 157, a staple cartridge, such as staple cartridge 4800, for example, can comprise a crushable cartridge body 4810 comprising an outer layer 4811 and an inner layer 4812, wherein the inner layer 4812 can comprise a corrugated, honeycomb-configured, lattice having a plurality of pockets, or cavities, 4815 defined therein. In various embodiments, the walls defining the lattice of inner layer 4812 can comprise one or more weakened, or thin, cross-sections 4819 which can be configured to allow the walls defining the lattice to break when the cartridge body 4810 is compressed. In such circumstances, the cartridge body 4810 can be crushed when the staple cartridge 4800 is implanted.

In various embodiments, referring now to FIGS. 158-160, a staple cartridge, such as staple cartridge 4900, for example, can comprise a cartridge body 4910 comprising an outer layer 4911 and a plurality of collapsible elements 4912 positioned intermediate top and bottom portions of the outer layer 4911, for example. Referring primarily to FIGS. 158 and 159, the staple cartridge 4900 can further comprise a plurality of staples 4920, wherein each staple 4920 can be positioned in a collapsible element 4912. More particularly, each collapsible element 4912 can comprise a first portion 4912a, a second portion 4012b, and a third portion 4012c which can co-operate to define a cavity 4915 therein which is configured to receive a staple 4920. In use, further to the above, the staple cartridge 4900 can be positioned within a staple cartridge channel and a compressive force can be applied to the tissue contacting surface 4919 in order to compress the cartridge body 4910. As the tissue contacting surface 4919 is moved downwardly, the collapsible elements 4912 can collapse. In such circumstances, the second portion 4912b of each collapsible element 4912 can collapse into a corresponding first portion 4912a and, similarly, the third portion 4912c of each collapsible element 4912 can collapse into a corresponding second portion 4912b. As the cartridge body 4910 is compressed and the collapsible elements 4912 are collapsed, the staples 4920 positioned within the collapsible elements 4912 can be deformed, as illustrated in FIG. 160. In various embodiments, the second portion 4912b of each collapsible element 4912 can be frictionally engaged and/or press-fit within a corresponding first portion 4912a such that, once the compressive force applied to the collapsible element 4912 exceeds the retention force retaining the first portion 4912a and the second portion 4912b in their extended position (FIG. 159), the first portion 4912a and the second portion 4912b can begin to slide relative to one another. Similarly, the third portion 4912c of each collapsible element 4912 can be frictionally engaged and/or press-fit within a corresponding second portion 4912b such that, once the compressive force applied to the collapsible element 4912 exceeds the retention force retaining the second portion 4912b and the third portion 4912c in their extended position (FIG. 159), the second portion 4912b and the third portion 4912c can begin to slide relative to one another.

In many embodiments described herein, a staple cartridge can comprise a plurality of staples therein. In various embodiments, such staples can be comprised of a metal wire deformed into a substantially U-shaped configuration having two staple legs. Other embodiments are envisioned in which staples can comprise different configurations such as two or more wires that have been joined together having three or more staple legs. In various embodiments, the wire, or wires, used to form the staples can comprise a round, or at least substantially round, cross-section. In at least one embodiment, the staple wires can comprise any other suitable cross-section, such as square and/or rectangular cross-sections, for example. In certain embodiments, the staples can be comprised of plastic wires. In at least one embodiment, the staples can be comprised of plastic-coated metal wires. In various embodiments, a cartridge can comprise any suitable type of fastener in addition to or in lieu of staples. In at least one such embodiment, such a fastener can comprise pivotable arms which are folded when engaged by an anvil. In certain embodiments, two-part fasteners could be utilized. In at least one such embodiment, a staple cartridge can comprise a plurality of first fastener portions and an anvil can comprise a plurality of second fastener portions which are connected to the first fastener portions when the anvil is compressed against the staple cartridge. In certain embodiments, as described above, a sled or driver can be advanced within a staple cartridge in order to complete the forming process of the staples. In certain embodiments, a sled or driver can be advanced within an anvil in order to move one or more forming members downwardly into engagement with the opposing staple cartridge and the staples, or fasteners, positioned therein.

In various embodiments described herein, a staple cartridge can comprise four rows of staples stored therein. In at least one embodiment, the four staple rows can be arranged in two inner staple rows and two outer staple rows. In at least one such embodiment, an inner staple row and an outer staple row can be positioned on a first side of a cutting member, or knife, slot within the staple cartridge and, similarly, an inner staple row and an outer staple row can be positioned on a second side of the cutting member, or knife, slot. In certain embodiments, a staple cartridge may not comprise a cutting member slot; however, such a staple cartridge may comprise a designated portion configured to be incised by a cutting member in lieu of a staple cartridge slot. In various embodiments, the inner staple rows can be arranged within the staple cartridge such that they are equally, or at least substantially equally, spaced from the cutting member slot. Similarly, the outer staple rows can be arranged within the staple cartridge such that they are equally, or at least substantially equally, spaced from the cutting member slot. In various embodiments, a staple cartridge can comprise more than or less than four rows of staples stored within a staple cartridge. In at least one embodiment, a staple cartridge can comprise six rows of staples. In at least one such embodiment, the staple cartridge can comprise three rows of staples on a first side of a cutting member slot and three rows of staples on a second side of the cutting member slot. In certain embodiments, a staple cartridge may comprise an odd number of staple rows. For example, a staple cartridge may comprise two rows of staples on a first side of a cutting member slot and three rows of staples on a second side of the cutting member slot. In various embodiments, the staple rows can comprise staples having the same, or at least substantially the same, unformed staple height. In certain other embodiments, one or more of the staple rows can comprise staples having a different unformed staple height than the other staples. In at least one such embodiment, the staples on a first side of a cutting member slot may have a first unformed height and the staples on a second side of a cutting member slot may have a second unformed height which is different than the first height, for example.

In various embodiments, referring now to FIGS. 161A-161D, an end effector of a surgical stapler can comprise a cartridge attachment portion, such as staple cartridge channel 5030, for example, a fastener cartridge removably positioned in the staple cartridge channel 5030, such as staple cartridge 5000, for example, and a jaw 5040 positioned opposite the staple cartridge 5000 and the staple cartridge channel 5030. The staple cartridge 5000 can comprise a compressible body 5010 and a plurality of staples 5020, and/or any other suitable fasteners, at least partially positioned in the compressible body 5010. In at least one such embodiment, each staple 5020 can comprise a base 5022 and, in addition, legs 5021 extending upwardly from the base 5022, wherein at least a portion of the legs 5021 can be embedded in the cartridge body 5010. In various embodiments, the compressible body 5010 can comprise a top, or tissue-contacting, surface 5019 and a bottom surface 5018, wherein the bottom surface 5018 can be positioned against and supported by a support surface 5031 of the staple cartridge channel 5030. Similar to the above, the support surface 5031 can comprise a plurality of support slots 5032 (FIG. 161D), for example, defined therein which can be configured to receive and support the bases 5022 of the staples 5020. In various embodiments, the end effector of the surgical stapler can further comprise a retention matrix, such as retention matrix 5050, for example, which can be configured to engage the staples 5020 and capture tissue therebetween. In at least one such embodiment, the retention matrix 5050 can be removably mounted to the jaw 5040. In use, once the staple cartridge 5000 has been positioned within the staple cartridge channel 5030, the jaw 5040, and the retention matrix 5050 attached thereto, can be moved toward the staple cartridge 5000 and the staple cartridge channel 5030. In at least one embodiment, the jaw 5040 can be moved downwardly along an axis 5099 such that the jaw 5040 and the staple cartridge channel 5030 remain parallel, or at least substantially parallel, to one another as the jaw 5040 is closed. More particularly, in at least one such embodiment, the jaw 5040 can be closed in a manner such that a tissue-contacting surface 5051 of the retention matrix 5050 is parallel, or at least substantially parallel, to the tissue-contacting surface 5019 of the staple cartridge 5000 as the jaw 5040 is moved toward the staple cartridge 5000.

In various embodiments, referring now to FIG. 161A, the retention matrix 5050 can be detachably secured to the jaw 5040 such that there is little, if any, relative movement between the retention matrix 5050 and the jaw 5040 when the retention matrix 5050 is attached to the jaw 5040. In at least one embodiment, the jaw 5040 can comprise one or more retention features which can be configured to hold the retention matrix 5050 in position. In at least one such embodiment, the retention matrix 5050 can be snap-fit and/or press-fit into the jaw 5040. In certain embodiments, the retention matrix 5050 can be adhered to the jaw 5040 utilizing at least one adhesive. In any event, the jaw 5040 can be moved into a position in which the retention matrix 5050 is in contact with the tissue T and the tissue T is positioned against the tissue-contacting surface 5019 of the staple cartridge 5000. When the tissue T is positioned against the staple cartridge 5000 by the jaw 5040, the compressible body 5010 of the staple cartridge 5000 may or may not be compressed by the jaw 5040. In either circumstance, in various embodiments, the legs 5021 of the staples 5200 may not protrude through the tissue-contacting surface 5019 of the staple cartridge 5000 as illustrated in FIG. 161A. Furthermore, as also illustrated in FIG. 161A, the jaw 5040 can hold the tissue T against the compressible body 5010 without engaging the retention matrix 5050 with the staples 5020. Such embodiments can permit a surgeon to open and close the jaw 5040 multiple times in order to obtain a desired positioning of the end effector within a surgical site, for example, without damaging the tissue T. Other embodiments are envisioned, however, where the staple tips 5023 can protrude from the tissue-contacting surface 5019 prior to the cartridge body 5010 being compressed by the anvil 5040. Once the end effector has been suitably positioned, referring now to FIG. 161B, the jaw 5040 can be moved downwardly toward the staple cartridge channel 5030 such that the compressible body 5010 is compressed by the anvil 5040 and such that the tissue-contacting surface 5019 is pushed downwardly relative to the staples 5020. As the tissue-contacting surface 5019 is pushed downwardly, the tips 5023 of the staple legs 5021 can pierce the tissue-contacting surface 5019 and pierce at least a portion of the tissue T. In such circumstances, the retention matrix 5050 may be positioned above the staples 5020 such that the retention apertures 5052 of retention matrix 5050 are aligned, or at least substantially aligned, with the tips 5023 of the staple legs 5021.

As the retention matrix 5050 is pushed downwardly along the axis 5099, referring now to FIG. 161C, the staple legs 5021 of staples 5020 can enter into the retention apertures 5052. In various embodiments, the staple legs 5021 can engage the side walls of the retention apertures 5052. In certain embodiments, as described in greater detail below, the retention matrix 5050 can comprise one or more retention members extending into and/or around the retention apertures 5052 which can engage the staple legs 5021. In either event, the staple legs 5021 can be retained in the retention apertures 5052. In various circumstances, the tips 5023 of the staple legs 5021 can enter into the retention apertures 5052 and can frictionally engage the retention members and/or the side walls of the apertures 5052. As the retention matrix 5050 is pushed toward the bases 5022 of the staples 5020, the staple legs 5021 can slide relative to the side walls and/or the retention members. As a result of the above, sliding friction forces can be created between the staple legs 5021 and the retention matrix 5050 wherein such sliding friction forces can resist the insertion of the retention matrix 5050 onto the staples 5020. In various embodiments, the sliding friction forces between the retention matrix 5050 and the staples 5020 can be constant, or at least substantially constant, as the retention matrix 5050 is slid downwardly along the staple legs 5021 of the staples 5020. In certain embodiments, the sliding friction forces may increase and/or decrease as the retention matrix 5050 is slid downwardly along the staple legs 5021 owing to variations in geometry of the staple legs 5021, the retention apertures 5052, and/or the retention members extending into and/or around the retention apertures 5052, for example. In various embodiments, the insertion of the retention matrix 5050 onto the staples 5020 can also be resisted by the compressible body 5010 of the staple cartridge 5000. More particularly, the compressible body 5010 can be comprised of an elastic material, for example, which can apply a resistive force to the retention matrix 5050 which increases as the distance in which the compressible body 5010 is compressed increases. In at least one such embodiment, the increase in the resistive force generated by the cartridge body 5010 can be linearly proportional, or at least substantially linearly proportional, with respect to the distance in which the cartridge body 5010 is compressed. In certain embodiments, the increase in the resistive force generated by the cartridge body 5010 can be geometrically proportional with respect to the distance in which the cartridge body 5010 is compressed.

In various embodiments, further to the above, a sufficient firing force can be applied to the jaw 5040 and the retention matrix 5050 in order to overcome the resistive and friction forces described above. In use, the retention matrix 5050 can be seated to any suitable depth with respect to the staples 5020. In at least one embodiment, the retention matrix 5050 can be seated to a depth with respect to the bases 5022 of the staples 5020 in order to secure two or more layers of tissue together and generate compressive forces, or pressure, within the tissue. In various circumstances, the system comprising the retention matrix 5050 and the staples 5020 can allow a surgeon to select the amount of compressive forces, or pressure, that is applied the tissue by selecting the depth in which the retention matrix 5050 is seated. For example, the retention matrix 5050 can be pushed downwardly toward the staple bases 5022 of the staples 5020 until the retention matrix 5050 is seated a certain depth 5011 away from the bottom of the support slots 5032, wherein a shorter depth 5011 can result in higher compressive forces, or pressure, being applied to the tissue T than a taller depth 5011 which can result in lower compressive forces, or pressure, being applied to the tissue T. In various embodiments, the compressive forces, or pressures, applied to the tissue T can be linearly proportional, or at least substantially linearly proportional, to the depth 5011 in which the retention matrix 5050 is seated. In various circumstances, the compressive forces, or pressure, applied to the tissue T can depend on the thickness of the tissue T positioned between the retention matrix 5050 and the staple cartridge 5020. More particularly, for a given distance 5011, the presence of thicker tissue T can result in higher compression forces, or pressure, than the presence of thinner tissue T.

In various circumstances, further to the above, a surgeon can adjust the depth in which the retention matrix 5050 is seated in order to account for thicker and/or thinner tissue positioned within the end effector and to apply a certain or predetermined pressure to the tissue T regardless of the tissue thickness. For example, the surgeon can seat the retention matrix 5050 to a shorter depth 5011 when fastening thinner tissue T or a taller depth 5011 when fastening thicker tissue T in order to arrive at the same, or at least substantially the same, compression pressure within the tissue. In certain embodiments, further to the above, a surgeon can selectively determine the amount of compressive pressure to apply to the tissue T positioned between the retention matrix 5050 and the staple cartridge 5010. In various circumstances, a surgeon can engage the retention matrix 5050 with the staples 5020 and position the retention matrix 5050 a first distance away from the bases 5022 of the staples 5020 in order to apply a first compressive pressure to the tissue. The surgeon can alternatively position the retention matrix 5050 a second distance away from the bases 5022, which is shorter than the first distance, in order to apply a second compressive pressure to the tissue which is greater than the first pressure. The surgeon can alternatively position the retention matrix 5050 a third distance away from the bases 5022, which is shorter than the second distance, in order to apply a third compressive pressure to the tissue which is greater than the second pressure. In various embodiments, the fastening system comprising the retention matrix 5050 and the staples 5020 can be configured to permit a surgeon to apply a wide range of compressive pressures to the targeted tissue.

In various embodiments, referring now to FIG. 161D, the staple legs 5021 can be inserted through the retention matrix 5050 such that the staple leg tips 5023 extend above the top surface of the retention matrix 5050. In at least one embodiment, referring again to FIG. 161C, the jaw 5040 can further comprise clearance apertures 5042 defined therein which can be configured to receive the staple leg tips 5023 as they pass through the retention apertures 5052 in the retention matrix 5050. In at least one such embodiment, the clearance apertures 5042 can be aligned with the retention apertures 5052 such that the legs 5021 do not contact the jaw 5040. In various embodiments, the clearance apertures 5042 can have a sufficient depth such that the staple legs 5021 do not contact the jaw 5040 regardless of the distance in which the retention matrix 5050 is seated. After the retention matrix 5050 has been engaged with the staples 5020 and seated to a desired position, referring now to FIG. 161D, the staple cartridge channel 5030 and the jaw 5040 can be moved away from the tissue T. More particularly, the staple cartridge channel 5030 can be detached from the implanted staple cartridge 5000 and the anvil 5040 can be detached from the implanted retention matrix 5050. As the jaw 5040 is moved away from the retention matrix 5050 and the staple supports 5032 are moved away from the staple bases 5022, the distance 5011 between the retention matrix 5050 and the bottom of the bases 5022 can be maintained eventhough the jaw 5040 and the staple cartridge channel 5030 are no longer providing support thereto. In various embodiments, the static friction forces between the staple legs 5021 and the retention matrix 5050 can be sufficient to maintain the retention matrix 5050 in position despite a biasing force being applied to the retention matrix 5050 by the compressed cartridge body 5010 and/or the compressed tissue T. In at least one such embodiment, the cartridge body 5010 can be comprised of a resilient material which, when compressed, can apply an elastic biasing force to the retention matrix 5050 and the staples 5020 in a manner which tends to push the retention matrix 5050 and the staples 5020 apart, although such movement is opposed by the frictional engagement between the staple legs 5021 and the retention matrix 5050.

In various embodiments, as described above, a retention matrix can comprise a plurality of retention apertures, wherein each retention aperture can be configured to receive a leg of a fastener therein. In at least one embodiment, referring now to FIG. 162, a portion of a retention matrix 5150 is illustrated therein which can comprise a retention aperture 5152 defined by a perimeter 5156. In various embodiments, the perimeter 5156 of the aperture 5152 can comprise a circular, or at least substantially circular, profile and/or any other suitable profile. In certain embodiments, the retention matrix 5150 can comprise one or more retention members, such as retention members 5153, for example, which extend into the aperture 5152 and can be configured to engage a fastener leg when the fastener leg is inserted therethrough. In at least one such embodiment, each retention member 5153 can comprise a cantilever which extends inwardly toward a center axis 5159, i.e., toward the center of the aperture 5152. In various embodiments, each cantilever can comprise a first end which is attached to the retention matrix body 5158 and a second end which forms the perimeter 5156 of the retention aperture 5152. In certain embodiments, the perimeter 5156 of a retention aperture 5152 can be defined by a first diameter, or width, and a fastener leg can be defined by a second diameter, or width, wherein the second diameter can be larger than the first diameter. In at least one such embodiment, the fastener leg can be configured to contact and deflect one or more of the retention members 5153 in order to increase the diameter of the retention aperture 5152 as the fastener leg is being inserted therethrough. In certain embodiments, further to the above, the fastener leg can define a perimeter which is larger than the perimeter 5156 of the retention aperture 5152 such that the fastener leg can expand the perimeter 5156 when the fastener leg is inserted therein.

In various embodiments, referring again to FIG. 162, the aperture 5152 can be defined by the deformable members 5153, wherein each deformable member 5153 can be configured to deflect relative to, or independently of, the other deformable members 5153. In at least one such embodiment, adjacent deformable members 5153 can be separated by slots 5154 which can be configured to permit each deformable member 5153 to flex relative to the others. In certain embodiments, each slot 5154 can comprise a first end 5155 in the retention matrix body 5158, a second end opening into the retention aperture 5152, and a constant, or at least substantially constant, width extending between the first end 5155 and the second end. In various other embodiments, the width of each slot 5154 may not be constant and each slot 5154 may increase and/or decrease in width between the first and second ends thereof. In certain embodiments, the first ends 5155 of the slots 5154 can comprise an enlarged portion, such as a circular portion, which can provide, one, strain relief to the bases of the deformable members 5153 attached to the retention matrix body 5158 and, two, means for increasing the flexibility of the deformable members 5153. In various embodiments, the geometry of the deformable members 5153, and/or slots 5154, can be selected so as to provide the deformable members 5153 with a desired flexibility. In certain embodiments, for example, the slots 5154 can be lengthened in order to create longer deformable members 5153 which can be more flexible than deformable members 5153 having a shorter length. In at least one embodiment, the width of each deformable member 5153 can be selected so as to provide a desired flexibility thereof. More particularly, deformable members having a thinner width can be more flexible than deformable members having a thicker width. In certain embodiments, referring again to FIG. 162, the first ends of the cantilevers of deformable members 5153 attached to the retention matrix body 5158 can be wider than the second ends of the cantilevers. In at least one such embodiment, the cantilevers can be tapered in a linear, or at least substantially linear, manner between the first and second ends thereof.

In various embodiments, referring again to FIG. 162, the retention matrix body 5158 can comprise a flat, or at least substantially flat, sheet of material having a tissue-contacting surface 5151 and a top surface 5157. In at least one such embodiment, the tissue-contacting surface 5151 and the top surface 5157 can be parallel, or at least substantially parallel, to one another. In various embodiments, each deformable member 5153 can comprise a first portion 5153a and a second portion 5153b, wherein the first portion 5153a can extend in a first direction and the second portion 5153b can extend in a different, or second, direction. In at least one such embodiment, the retention matrix body 5158 can define a plane and the first portions 5153a of the deformable members 5153 can lie within such a plane. In various embodiments, the second portions 5153b of the deformable members 5153 can extend at an angle relative to the first portions 5153a. In at least one such embodiment, the second portions 5153b can extend in directions which are pointed away from the top surface 5157 of the retention matrix body 5158 and, in certain embodiments, the second portions 5153b can converge toward the central axis 5159 of the retention aperture 5152. In any event, in various embodiments, the second portions 5153b can be configured to deflect away from the central axis 5159 when the fastener leg is inserted therethrough. In embodiments where a staple leg 5021 of a staple 5020 is inserted into a retention aperture 5152, the deformable members 5153 can deform in a direction which is generally away from the bases 5122 of the staples 5120. In certain embodiments, as a result, the deformable members 5153 can deflect in a general direction which is the same as, or at least substantially the same as, the direction in which the staple legs 5021 are being inserted.

In various embodiments, referring again to FIG. 162, the second portions 5153b of the deformable members 5153 can each comprise a sharp tip, for example, which can be configured to slide against a staple leg 5021 as the staple leg 5021 is inserted therein. The sharp tips of the second portions 5153b can also be configured to bite into the staple leg 5021 in the event that the staple leg 5021 were to be pulled in the opposite direction, i.e., in a direction which would remove the staple leg 5021 from the retention aperture 5052. In certain circumstances, the second portions 5153b can be inclined at an angle relative to the side of the staple leg 5021 which is greater than 90 degrees and, as a result, the second portions 5153b may dig, or burrow, into the side of the staple leg 5021 when the staple leg 5021 experiences a force which tends to withdraw the staple leg 5021 from the retention aperture 5052. In certain embodiments, the staple legs 5021 can comprise indentations and/or concavities, such as microindentations, for example, in the surfaces thereof which can be configured to receive the tips of the deformable members 5053, for example, therein. In at least one such embodiment, the tips of the deformable members 5053 can catch in and burrow into the indentations in the staple legs 5021 when a withdrawing force is applied to the staple legs 5021. In various embodiments, as a result of the burrowing of the second portions 5153b into the staple legs 5021, forces acting to remove the staple legs 5021 from the retention apertures 5022 may only seat the second portions 5153b deeper into the staple legs 5021 and increase the force required to remove the staple legs 5021. Furthermore, owing to the upward inclination of the second portions 5153b, in at least one embodiment, the second portions 5153b can be more permissive to the insertion of a staple leg 5021 within a retention aperture 5152 and more resistive to withdrawal of the staple leg 5021. In at least one embodiment, as a result, the force required to insert a staple leg 5021 into a retention aperture 5022 may be less than the force required to remove the staple leg 5021 from the retention aperture 5022. In various embodiments, the force needed to remove the staple leg 5021 from the retention aperture 5022 can be approximately 50 percent greater than the force needed to insert the staple leg 5021 into the retention aperture 5022, for example. In various other embodiments, the force needed to remove the staple leg 5021 may between approximately 10 percent and approximately 100 percent greater than the force needed to insert the staple leg 5021, for example. In certain embodiments, the force needed to remove the staple leg 5021 may be approximately 100 percent, approximately 150 percent, approximately 200 percent, and/or greater than approximately 200 percent larger than the force needed to insert the staple leg 5021, for example.

In certain embodiments, referring again to FIG. 162, the second portions 5153b can be arranged circumferentially around the aperture 5152 and can define a pocket therebetween. More particularly, the second portions 5153b can define a pocket 5160 which can be configured to receive the tip of the fastener leg when it is inserted into the retention aperture 5152. In various embodiments, the second portions 5153b of the deformable members 5153 can comprise an annular, or an at least substantially annular, contour which can co-operatively define an annular, or at least substantially annular, profile of the pocket 1560, for example. In at least one such embodiment, the second portions 5153b can define a conical or frustoconical pocket. In various embodiments, the pocket can be defined by a suitable number of deformable members, such as four deformable members 5153 (FIG. 162), six deformable members 5153 (FIG. 163), or eight deformable members 5153 (FIG. 164), for example. In certain embodiments, referring now to FIG. 165, the deformable members of a retention matrix, such as retention matrix 5250, for example, can form a pyramidal shape, or an at least substantially pyramidal shape, for example. In various embodiments, a retention matrix 5250 can comprise a plurality of retention apertures, such as retention aperture 5252, for example, which can be defined by a perimeter 5256. In various embodiments, the perimeter 5256 can comprise a polygonal, or at least substantially polygonal, profile and/or any other suitable profile. In certain embodiments, the retention matrix 5250 can comprise one or more retention members, such as retention members 5253, for example, which extend into the aperture 5252 and can be configured to engage a fastener leg when the fastener leg is inserted therethrough. In at least one such embodiment, each retention member 5253 can comprise a cantilever which extends inwardly toward a center axis 5259, i.e., toward the center of the aperture 5252. In various embodiments, each cantilever can comprise a first end which is attached to the retention matrix body 5258 and a second end which forms the perimeter 5256 of the retention aperture 5252. In certain embodiments, the perimeter 5256 of a retention aperture 5252 can be defined by a first diameter, or width, and a fastener leg can be defined by a second diameter, or width, wherein the second diameter can be larger than the first diameter. In at least one such embodiment, the fastener leg can be configured to contact and deflect one or more of the retention members 5253 in order to increase the diameter of the retention aperture 5252 as the fastener leg is being inserted therethrough. In certain embodiments, further to the above, the fastener leg can define a perimeter which is larger than the perimeter 5256 of the retention aperture 5252 such that the fastener leg can expand the perimeter 5256 when the fastener leg is inserted therein.

In various embodiments, referring again to FIG. 165, the aperture 5252 can be defined by the deformable members 5253, wherein each deformable member 5253 can be configured to deflect relative to, or independently of, the other deformable members 5253. In at least one such embodiment, adjacent deformable members 5253 can be separated by slots 5254 which can be configured to permit each deformable member 5253 to flex relative to the others. In various embodiments, the retention matrix body 5258 can comprise a flat, or at least substantially flat, sheet of material having a tissue-contacting surface 5251 and a top surface 5257. In at least one such embodiment, the tissue-contacting surface 5251 and the top surface 5257 can be parallel, or at least substantially parallel, to one another. In various embodiments, each deformable member 5253 can comprise a first portion 5253a and a second portion 5253b, wherein the first portion 5253a can extend in a first direction and the second portion 5253b can extend in a different, or second, direction. In at least one such embodiment, the retention matrix body 5258 can define a plane and the first portions 5253a of the deformable members 5253 can lie within such a plane. In various embodiments, the second portions 5253b of the deformable members 5253 can extend at an angle relative to the first portions 5253a. In at least one such embodiment, the second portions 5253b can extend in directions which are pointed away from the top surface 5257 of the retention matrix body 5258 and, in certain embodiments, the second portions 5253b can converge toward the central axis 5259 of the retention aperture 5252. In any event, in various embodiments, the second portions 5253b can be configured to deflect away from the central axis 5259 when the fastener leg is inserted therethrough. In certain embodiments, referring again to FIG. 165, the second portions 5253b can be arranged circumferentially around the aperture 5252 and can define a pocket therebetween. More particularly, the second portions 5253b can define a pocket which can be configured to receive the tip of the fastener leg when it is inserted into the retention aperture 5252. In various embodiments, the second portions 5253b of the deformable members 5253 can define a polygonal, or an at least substantially polygonal, pocket, for example. In various embodiments, the pocket can be defined by a suitable number of deformable members, such as four deformable members 5253 (FIG. 165) which can define a square, six deformable members 5253 (FIG. 166) which can define a hexagon, or eight deformable members 5253 (FIG. 167) which can define an octagon, for example.

In various embodiments, referring now to FIG. 168, a retention matrix, such as retention matrix 5350, for example, can be formed from a flat, or an at least substantially flat, sheet of material such as titanium and/or stainless steel, for example. In at least one such embodiment, a plurality of apertures 5352 can be formed in the body 5358 of the retention matrix 5350 by one or more stamping processes. The sheet of material can be positioned in a stamping die which, when actuated, can punch out certain portions of the material in order to form slots 5354, apertures 5355 of slots 5354, and/or the perimeter 5356 of the retention aperture 5352, for example. The stamping die can also be configured to bend the deformable members 5353 in a suitable configuration. In at least one such embodiment, the stamping die can deform the second portions 5353b upwardly relative to the first portions 5353a along a crease line 5353c. In various embodiments, referring now to FIG. 169, a retention matrix, such as retention matrix 5450, for example, can comprise a plurality of retention apertures 5452. Similar to the above, the perimeter 5456 of each retention aperture 5452 can be defined by a plurality of deformable members 5453 separated by slots, or slits, 5454. In at least one such embodiment, the entirety of each deformable member 5453 can be bent upwardly wherein the free ends of the cantilevers comprising the deformable members 5453 can define the perimeter 5456. In various embodiments, the retention matrix 5450 can comprise a plurality of apertures 5455 surrounding, or at least substantially surrounding, the retention aperture 5452. In at least one such embodiment, the apertures 5455 can be arranged in a circular array surrounding or enclosing a perimeter defined by the fixed ends of the cantilevers of the deformable members 5453. In certain embodiments, each aperture 5455 can comprise a circular, or at least substantially circular, perimeter and/or any other suitable perimeter. In use, the apertures 5455 can provide, one, strain relief to the bases of the deformable members 5453 attached to the retention matrix body 5458 and, two, means for increasing the flexibility of the deformable members 5453. In various embodiments, larger apertures 5455 can provide more flexibility to the deformable members 5453 as compared to smaller apertures 5455. Furthermore, apertures 5455 which are closer to the deformable members 5453 can provide more flexibility as compared to apertures 5455 which are further away.

In various embodiments, referring now to FIG. 170, a retention matrix, such as retention matrix 5550, for example, can comprise a plurality of retention apertures 5552. Each retention aperture 5552 can comprise an elongate slot 5554 having enlarged circular, or at least substantially circular, ends 5555. In at least one such embodiment, the ends 5555 can be defined by a diameter which is wider than the slot 5554. In certain embodiments, the elongate slot 5554 and the ends 5555 can positioned along, and/or centered along, a longitudinal axis 5559. In various embodiments, the slot 5554 and the ends 5555 can define two opposing tabs 5553 which can be configured to engage a leg of a fastener and deflect as the fastener leg is inserted therethrough. In at least one embodiment, ends 5555 having a larger perimeter, or diameter, can define longer tabs 5553 which can be more flexible than tabs 5553 defined by ends 5555 having a smaller perimeter, or diameter. In various embodiments, the ends 5555 can have the same perimeter and diameter and, in at least one such embodiment, each tab 5553 can be symmetrical about an axis which is perpendicular, or at least substantially perpendicular, to the longitudinal axis 5559. Alternatively, the ends 5555 can have different perimeters and/or diameters wherein, in at least one embodiment, each tab 5553 may not be symmetrical about its axis. In at least one such alternative embodiment, the tabs 5553 may twist about their axes as the fastener leg is inserted through the retention aperture 5552. In various embodiments, referring now to FIG. 171, a retention matrix, such as retention matrix 5650, for example, can comprise a plurality of retention apertures 5652. Each retention aperture 5652 can comprise an elongate slot 5654 comprising circular, or at least substantially circular, ends 5655. In at least one such embodiment, the elongate slot 5654 and the ends 5655 can be positioned along, and/or centered along, a longitudinal axis 5659. In various embodiments, each end 5655 can be defined by a diameter which is the same as, or at least substantially the same as, the width of the slot 5654.

In various embodiments, referring now to FIG. 172, a retention matrix, such as retention matrix 5750, for example, can comprise a plurality of retention apertures 5752. Each retention aperture 5752 can comprise a plurality of slots, such as slots 5754, for example, having enlarged ends 5755. In at least one such embodiment, the slots 5754 and the ends 5755 can be positioned along and/or centered along longitudinal axes 5759. In various embodiments, the axes 5759 can extend in directions which are perpendicular or transverse to one another. In certain embodiments, the slots 5754 and the ends 5755 can define four tabs 5753, for example, which can be configured to engage a fastener leg and deflect when the fastener leg is inserted through the retention aperture 5752. In at least one embodiment, each tab 5753 can comprise a triangular, or at least substantially triangular, configuration, such as an equilateral triangle, for example. In various other embodiments, referring now to FIG. 173, a retention matrix, such as retention matrix 5850, for example, can comprise a plurality of retention apertures 5852. Each retention aperture 5852 can comprise a plurality of slots, such as slots 5854, for example, having ends 5855, wherein the slots 5854 and the ends 5855 can be positioned along and/or centered along longitudinal axes 5859. In various embodiments, the axes 5859 can extend in directions which are perpendicular or transverse to one another. In certain embodiments, the slots 5854 and the ends 5855 can define tabs 5853 which can be configured to engage a fastener leg and deflect when the fastener leg is inserted through the retention aperture 5852. In at least one embodiment, each tab 5853 can comprise an arcuate profile. More particularly, each tab 5853 can comprise a curved end, as opposed to a pointed end depicted in FIG. 170, which can be configured to contact the fastener leg.

In various embodiments, referring now to FIG. 174, a retention matrix, such as retention matrix 5950, for example, can comprise a plurality of retention apertures 5952. Each retention aperture 5952 can comprise a plurality of slots, such as slots 5954, for example, wherein each slot 5954 can extend along, and/or can be centered along, an axis 5959. In various embodiments, the axes 5959 can be transverse to each other and, in at least one such embodiment, the axes 5959 can be arranged such that all of the axes 5959 extend through a center of the retention aperture 5952 and are spaced equidistantly, or at least substantially equidistantly, from each other. In at least one embodiment, each slot 5954 can comprise an open end facing the center of the retention aperture 5952 and a second, or closed, end 5955 at the opposite end of the slot 5954. Similar to the above, the slots 5954 and the ends 5955 can define three tabs 5953, for example, which can be configured to engage a fastener leg and deflect when the fastener leg is inserted into the retention aperture 5952. In various embodiments, each tab 5953 can comprise an arcuate configuration extending between adjacent ends 5955 of the slots 5954. In various embodiments, referring now to FIG. 175, a retention matrix, such as retention matrix 6050, for example, can comprise a plurality of retention apertures 6052. Each retention aperture 6052 can comprise a tab 6053 which can be configured to engage a fastener leg and to deflect when the fastener leg is inserted into the retention aperture 6052. In at least one such embodiment, the tab 6053 can comprise a base fixed to the retention matrix body 6058 and a free end comprising an arcuate or curved profile 6056 which can be configured to contact the fastener leg. In certain embodiments, the fastener leg can be a staple leg comprised of a round wire wherein the curved profile 6056 can be configured to match, or at least substantially match, a curved outer surface of the round wire.

In various embodiments, referring again to FIG. 175, the retention matrix body 6058 can comprise a plurality of slots 6054 and apertures 6055 which can be configured to define the tab 6053 and various portions of the retention aperture 6052. In at least one embodiment, the tab 6053 can comprise a rectangular configuration comprising parallel, or at least substantially parallel, sides. In certain embodiments, referring now to FIG. 176, a retention matrix, such as retention matrix 6150, for example, can comprise a plurality of retention apertures 6152. Each retention aperture 6152 can comprise a tab 6153 which can be configured to engage a fastener leg and to deflect when the fastener leg is inserted into the retention aperture 6152. In at least one such embodiment, the tab 6153 can comprise a base fixed to the retention matrix body 6158 and a free end comprising an arcuate or curved profile 6156 which can be configured to contact the fastener leg. In various embodiments, the retention matrix body 6158 can comprise a plurality of slots 6154 and apertures 6155 which can be configured to define the tab 6153 and various portions of the retention aperture 6152. In at least one embodiment, the tab 6153 can comprise a tapered configuration comprising arcuate sides. In at least one such embodiment, the tab 6153 can taper geometrically with the base being wider than the free end, for example.

In various embodiments, as described above, a fastening system can comprise a plurality of staples comprising staple legs which are inserted through a plurality of retention apertures in a retention matrix. In certain embodiments, as described in greater detail below, the staples can be held in a first jaw and the retention matrix can be held in a second jaw, wherein at least one of the first jaw and the second jaw can be moved toward the other. In various circumstances, the staples positioned within the first jaw can be secured therein such that the staple legs are aligned with the retention apertures when the retention matrix is engaged with the staple legs. In certain embodiments, referring to FIGS. 177 and 178, a fastener system can comprise a staple cartridge 6200, for example, positioned in a first jaw of a surgical stapler and a retention matrix 6250, for example, positioned in a second jaw of the surgical stapler. Referring now to FIGS. 184 and 185, further to the above, the retention matrix 6250 can comprise a plurality of retention apertures 6252, wherein each retention aperture 6252 can comprise a perimeter 6256 defined by one or more deflectable members 6253. In at least one such embodiment, further to the above, the deflectable members 6253 defining each aperture 6252 can define a pocket 6201. In various embodiments, each pocket 6201 can comprise a curved and/or concave surface, for example, which can be configured to guide a tip of a staple leg into the aperture 6252 in the event that the staple leg is misaligned with the retention aperture 6252 and initially contacts the deflectable members 6253 and/or the tissue-contacting surface 6251, for example.

In various embodiments, further to the above, the fastening system can further comprise a plurality of staples 6220 comprising staple legs 6221 which can be inserted through the retention apertures 6252 in the retention matrix 6250. In at least one such embodiment, each staple 6220 can comprise a substantially U-shaped configuration, for example, comprising a base 6222 from which the staple legs 6221 can extend upwardly. In various embodiments, referring now to FIGS. 180 and 181, the retention apertures 6252 in the retention matrix 6250 can be arranged in two parallel, or at least substantially parallel, longitudinal rows, for example, which can extend along, or parallel to, a longitudinal axis of the retention matrix. In certain embodiments, the retention apertures 6252 in a first row can be offset, or staggered, with respect to the retention apertures 6252 in a second row. In at least one such embodiment, each staple 6220 can comprise a first staple leg 6221 positioned in a retention aperture 6252 in the first row of and a second staple leg 6221 positioned in a retention aperture 6252 in the second row wherein, as a result, the bases 6222 can extend in a direction which is transverse to the longitudinal axis of the retention matrix 6250. In at least one such embodiment, the staples 6220 can be parallel, or at least substantially parallel, to one another. More particularly, a base 6222a of a staple 6220a be parallel to, or at least substantially parallel to, a base 6222b of a staple 6220b which can be parallel to, or at least substantially parallel to, a base 6222c of a staple 6220c, for example. In at least one embodiment, the staple legs 6221a of staple 6220a can define a plane which is parallel to, or at least substantially parallel to, a plane defined by the staple legs 6221b of staple 6220b which can be parallel to, or at least substantially parallel to, a plane defined by the staple legs 6221 of staple 6220c, for example.

In various embodiments, referring now to FIGS. 177 and 179, the staple cartridge 6200 can comprise a plurality of staples 6220 and, in addition, an alignment matrix 6260 comprising a plurality of alignment guides, such as slots, grooves, and/or apertures, for example, which can be configured to align the staples 6220. In various circumstances, the alignment matrix 6260 can be configured such that the staple legs 6221 of the staples 6220 are aligned with the retention apertures 6252 in the retention matrix 6250 before the retention matrix 6250 is engaged with the staple legs 6221. In various embodiments, referring now to FIGS. 182 and 183, the alignment matrix 6260 can comprise a plurality of alignment apertures 6262 which can be configured to closely receive the staple legs 6221 of the staples 6220. In at least one such embodiment, each staple 6220 can comprise a base 6222 and two staple legs 6221 extending from the base 6222 wherein the bases 6222 of the staples 6220 can extend around a bottom surface 6264 of the retention matrix 6260 and the staple legs 6221 can extend upwardly through the alignment apertures 6262. In certain embodiments, each alignment aperture 6262 can be circular, or at least substantially circular, and can be defined by a diameter which is equal to or slightly larger than the diameter of the staple leg 6221 extending therethrough. In various embodiments, the alignment matrix 6260 can further comprise a plurality of raised members 6263 which can extend upwardly from the top surface 6261 of the alignment matrix 6260 and surround, or at least partially surround, the alignment apertures 6262. In certain embodiments, the raised members 6263 can provide for longer alignment apertures 6262 wherein, in various circumstances, longer apertures 6262 can provide more control over the alignment of the staple legs 6221 than shorter apertures 6262.

In use, in various embodiments, a first jaw supporting the staple cartridge 6200 can be positioned on one side of the tissue that is to be stapled and a second jaw supporting the retention matrix 6250 can be positioned on the other side of the tissue. Once the jaws have been suitably positioned relative to the tissue, in certain embodiments, the second jaw and the retention matrix 6250 can be moved toward the staple cartridge 6200. As the staple legs 6221 are being inserted through the retention apertures 6252 of the retention matrix 6250, in various embodiments, a tissue-contacting, or bottom, surface 6251 of the retention matrix 6250 can contact the tissue and press the tissue against the tissue-contacting, or top, surface 6261 of the alignment matrix 6260. In various other embodiments, as described in greater detail further below, the staple cartridge 6200 can further comprise a compressible cartridge body positioned above the top surface 6261 of the alignment matrix 6260, for example, which can contact the tissue. In certain embodiments, referring again to FIGS. 179 and 183, the alignment matrix 6260 can further comprise one or more apertures 6203 defined therein which, when the alignment matrix 6260 is positioned against tissue, can be configured to receive a portion of the tissue therein. In embodiments where a compressible cartridge body is positioned above and/or against the alignment matrix 6260, a portion of the compressible cartridge body can enter into the apertures 6203 when the cartridge body is compressed. Similarly, the retention matrix 6250 can comprise a plurality of apertures 6202 which can be configured to receive at least a portion of the tissue therein when the retention matrix 6250 is positioned against the tissue.

As the staple legs 6221 of the staples 6220 are inserted through the retention apertures 6252 of the retention matrix 6250, further to the above, the tips of the staple legs 6221 may protrude upwardly from the top surface 6257 of the retention matrix 6250. In various circumstances, as described above, the tips of the staple legs 6221 may remain unbent after they have been inserted through the retention apertures 6252. In certain embodiments, referring now to FIGS. 186-189, a fastening system comprising the staple cartridge 6200 and the retention matrix 6250 may further comprise a plurality of protective caps or covers, such as caps 6270, for example, which can be assembled to the staple legs 6221 protruding above the retention matrix 6250. In various embodiments, each cap 6270 can entirely, or at least partially, cover the sharp end of a staple leg 6221 such that the sharp end does not contact tissue positioned adjacent thereto. In at least one embodiment, referring now to FIG. 189, each cap 6270 can comprise an aperture 6271 defined therein which can be configured to closely receive a tip of a staple leg 6221 therein. In various embodiments, the caps 6270 can be comprised of an elastomeric material, such as silicone, polyisoprene, sanoprene, and/or natural rubber, for example. In at least one embodiment, the aperture 6271 can comprise a perimeter or diameter which is smaller than the perimeter or diameter of the staple leg 6221 inserted therein. In at least one such embodiment, the aperture 6271 in the protective cap 6270 can expand in order to receive the staple leg 6221 therein. In various alternative embodiments, the caps 6270 may not comprise apertures and the tips of the staple legs 6221 can be configured to incise the caps 6270 as the legs 6221 are inserted therein. In any event, in various embodiments, each cap 6270 can be seated onto a staple leg 6221 until the base 6272 of the cap 6270 abuts, or is positioned adjacent to, the top surface 6257 of the retention matrix 6250. In various circumstances, the caps 6270 can be configured such that they are seated snugly onto the tips of the staple legs 6221 such that they are not easily removed therefrom. In certain embodiments, each cap 6270 can comprise a conical, or at least substantially conical, outer surface, for example. In various embodiments, the caps 6270 can comprise any suitable shape, such as shapes comprising a parabolic, or at least substantially parabolic, outer surface, for example.

In various embodiments, the fastener system described above, for example, could be deployed using the surgical stapler depicted in FIGS. 190-192, for example. In various embodiments, the end effector can comprise a first jaw, or staple cartridge channel, 6230 which can be configured to support the staple cartridge 6200 therein and a second jaw 6240 which can be configured to support the retention matrix 6250 and the plurality of protective caps 6270. Referring primarily to FIG. 190, which illustrates the second jaw 6240 in an open configuration, the jaws 6230 and 6240 can be positioned relative to tissue T such that the tissue T is positioned intermediate the retention matrix 6250 and the staple cartridge 6200. In various embodiments, as discussed above, the staple cartridge 6200 can further comprise a compressible cartridge body, such as cartridge body 6210, for example, in which the staples 6220 and the alignment matrix 6260 can be positioned. In at least one such embodiment, the tissue T can be positioned against a top surface of the cartridge body 6210. In certain embodiments, the second jaw 6240 can comprise a plurality of recesses, or apertures, 6245 configured to receive the plurality of protective caps 6270 and, in addition, one or more retention features, or retainers, which can be configured to hold the retention matrix 6250 in position over the caps 6270. In at least one such embodiment, the retention matrix 6250 can be configured to retain the caps 6270 in the apertures 6245. In various embodiments, referring now to FIG. 202, each aperture 6245 can be configured to receive a portion of, or the entirety of, a cap 6270 therein. In certain embodiments, the apertures 6245 can be sufficiently sized and configured such that the caps 6270 can be secured therein by at least one of a press-fit and/or snap fit arrangement, for example. In some embodiments, at least one adhesive could be utilized to secure the caps 6270 in the apertures 6245. In at least one such embodiment, such an adhesive could be selected such that caps 6270 can detach from the second jaw 6240 after the caps 6270 have been engaged with the staple legs 6221 and the second jaw 6240 is moved away from the implanted fastener assembly. In certain embodiments, referring now to FIG. 203, the second jaw 6240 can further comprise at least one cover sheet 6246 which can be assembled to the second jaw 6240 and can extend over and retain the caps 6270 in the apertures 6245. In at least one such embodiment, at least a portion of the cover sheet 6246 can be secured to the jaw 6240 utilizing at least one adhesive, for example. In use, in at least one embodiment, the cover sheet 6246 can be at least partially detached from the jaw 6240 before the end effector is inserted into a surgical site. In certain embodiments, the cover sheet 6246 can be comprised of an implantable material, such as PDS and/or PGA, for example, which can be incised by the staple legs 6221 as the staple legs 6221 emerge from the retention matrix 6250. In at least one such embodiment, the cover sheet 6246 can be secured in the fastening system intermediate the covers 6270 and the retention matrix 6250.

Further to the above, referring now to FIG. 191, the jaw 6240 can be moved from an open position to a closed position in which the tissue T is positioned against the retention matrix 6250 and the cartridge body 6210. In such a position, the retention matrix 6250 may not yet be engaged with the staples 6220. In various embodiments, the jaw 6240 can be moved between its open position and its closed position by an actuator 6235. In at least one such embodiment, the jaw 6240 can comprise a distal pin 6243 and a proximal pin 6244 extending therefrom, wherein the distal pin 6243 can slide vertically, or at least substantially vertically, within a distal slot 6233 defined in the cartridge channel 6230, and wherein the proximal pin 6244 can slide vertically, or at least substantially vertically, within a proximal slot 6234 which is also defined in the staple cartridge channel 6230. In use, the actuator 6235 can be retracted proximally in order to drive the pins 6243 and 6244 into the upper ends of their respective slots 6233 and 6234 as illustrated in FIG. 191. In at least one such embodiment, the actuator 6235 can comprise a distal drive slot 6236 and a proximal drive slot 6237, wherein the sidewalls of the drive slots 6236 and 6237 can be configured to contact the distal pin 6243 and the proximal pin 6244, respectively, and drive the pins 6243 and 6244 upwardly as the actuator 6235 is moved proximally. More particularly, as the actuator 6235 is moved proximally, the distal pin 6243 can slide up an inclined first portion 6236a of the distal drive slot 6236 into an intermediate, or second, portion 6236b and, similarly, the proximal pin 6244 can slide up an inclined first portion 6237a of the distal drive slot 6237 into an intermediate, or second, portion 6237b. As the pins 6243 and 6244 are both moved upwardly, the jaw 6240 can be rotated downwardly toward the tissue T into a closed position.

Further to the above, referring now to FIG. 192, the actuator 6235 can be pulled further proximally in order to push the second jaw 6240 downwardly toward the first jaw 6230, compress the cartridge body 6210, and engage the retention matrix 6250 and the plurality of protective caps 6270 with the staple legs of the staples 6220. In at least one such embodiment, the additional proximal movement of the actuator 6235 can cause the sidewalls of the drive slots 6236 and 6237 to contact the pins 6243 and 6244, respectively, and drive the pins 6243 and 6244 downwardly toward the bottom ends of the slots 6233 and 6234, respectively. In such circumstances, the actuator 6235 can be pulled proximally such that, one, the distal pin 6243 exits the second portion 6236b of the drive slot 6236 and enters into an inclined third portion 6236c and, similarly, the proximal pin 6244 exits the second portion 6237b of the drive slot 6237 and enters into an inclined third portion 6237c. As the pins 6243 and 6244 are both moved downwardly, the second jaw 6240 can move downwardly toward the first jaw 6230 into a fired position. In at least one such embodiment, the second jaw 6240 can be moved downwardly such that the retention matrix 6250 remains parallel, or at least substantially parallel, to the top surface of the cartridge body 6210 and/or parallel, or at least substantially parallel, to the alignment matrix 6260. In any event, once the retention matrix 6250 and the protective caps 6270 have been engaged with the staple legs 6221 of the staples 6220, as illustrated in FIG. 194, the second jaw 6240 can be returned to an open, or an at least substantially open, position. In at least one such embodiment, the actuator 6235 can be pushed distally in order to drive the pins 6243 and 6244 to the top ends of the slots 6233 and 6234, respectively, and then driven downwardly toward the bottom ends of the slots 6233 and 6234 once the pins have passed through the intermediate portions 6236b and 6237b of the respective drive slots 6236 and 6237. Once the second jaw 6240 has been opened, the first jaw 6230 can be detached from the implanted staple cartridge 6200 and the first and second jaws 6230, 6240 can be removed away from the implanted fastener assembly, as illustrated in FIG. 193.

Referring to FIG. 192 once again, the reader will note that the pins 6243 and 6244 are not illustrated as being seated in the very bottoms of their respective slots 6233 and 6234 eventhough the retention matrix 6250 and the caps 6270 have been engaged with the staple legs 6221. Such circumstances can arise when thick tissue T is positioned between the retention matrix 6250 and the cartridge body 6210. In circumstances where thinner tissue T is positioned between the retention matrix 6250 and the cartridge body 6210, referring now to FIG. 195, the pins 6243 and 6244 can be drive further downwardly into their respective slots 6233 and 6234 as illustrated in FIG. 197. In general, in at least one such embodiment, the actuator 6235 can be pulled proximally in order to drive the pins 6243 and 6244 upwardly and downwardly through the progressions described above and illustrated in FIGS. 195-197 and, owing to the thinner tissue T, the retention matrix 6250 and the protective caps 6270 can be driven further onto the staple legs 6221 of the staples 6220, as illustrated in FIGS. 198 and 199. In various embodiments, as a result of the adjustability afforded by the retention matrix 6250, the same, or at least substantially the same, compressive pressure can be obtained in the fastened tissue regardless of whether the tissue captured within the end effector is thick or thin. In certain embodiments, the adjustability afforded by the retention matrix 6250 can allow a surgeon can select whether to apply a larger compressive pressure or a smaller compressive pressure to the tissue by selecting the depth to which the retention matrix 6250 is seated. In at least one such embodiment, the range in which the retention matrix 6250 can be seated onto the staple legs 6221 can be determined by the lengths, or ranges, of the slots 6233 and 6234, for example.

In various embodiments, as described above, the protective caps 6270 can be comprised of a soft or flexible material, for example, which can be configured to grip the ends of the staple legs 6221. In certain embodiments, the protective caps 6270 can be comprised of a bioabsorbable plastic, polyglycolic acid (PGA) which is marketed under the trade name Vicryl, polylactic acid (PLA or PLLA), polydioxanone (PDS), polyhydroxyalkanoate (PHA), poliglecaprone 25 (PGCL) which is marketed under the trade name Monocryl, polycaprolactone (PCL), and/or a composite of PGA, PLA, PDS, PHA, PGCL and/or PCL, for example, and/or a biocompatible metal, such as titanium and/or stainless steel, for example. As illustrated in FIG. 189, in at least one embodiment, each cap 6270 can be unconnected to the other caps 6270. In certain other embodiments, one or more caps 6270 can be mounted to the retention matrix 6250. In at least one such embodiment, the caps 6270 can be connected to the retention matrix 6250 by at least one adhesive, for example, wherein the apertures 6271 in the caps 6270 can be aligned, or at least substantially aligned, with the retention apertures 6252 in the retention matrix 6270. In various embodiments, referring now to FIG. 200, a protective cap, such as a cap 6370, for example, can define an inner cavity, or dome, 6374 which can be configured to receive a tip of a staple leg 6221, for example, therein. In at least one such embodiment, the cap 6370 can comprise a bottom 6372 and an aperture 6371 extending through the bottom 6372. In various embodiments, the aperture 6371 can be defined by one or more deflectable members 6373 which can be configured to deflect when the staple leg 6221 is inserted therethrough. In certain embodiments, two or more caps 6370, for example, can be connected together to form an array of caps 6370. In at least one such embodiment, referring now to FIG. 201, a plurality of caps 6370 can be connected together by a sheet of material 6375. In certain embodiments, the sheet 6375 can be sufficiently rigid in order to maintain a desired arrangement and/or alignment of the caps 6370. In at least one embodiment, the caps 6370 can be comprised of a biocompatible metal, such as titanium and/or stainless steel, for example, and the sheet 6375 can be comprised of a bioabsorbable plastic, polyglycolic acid (PGA) which is marketed under the trade name Vicryl, polylactic acid (PLA or PLLA), polydioxanone (PDS), polyhydroxyalkanoate (PHA), poliglecaprone 25 (PGCL) which is marketed under the trade name Monocryl, polycaprolactone (PCL), and/or a composite of PGA, PLA, PDS, PHA, PGCL and/or PCL, for example. In various embodiments, a sheet 6375 can be comprised of a bioabsorbable material including an anti-microbial agent, such as colloidal silver and/or triclosan, for example, stored and/or dispersed therein which can be released as the sheet 6375 is bioabsorbed, for example.

In various embodiments, further to the above, the sheet 6375 can be injection molded around the caps 6370 utilizing an injection molding process, for example, such that the caps 6370 are embedded in the sheet 6375. In certain other embodiments, the sheet 6375 can be molded utilizing an injection molding process, for example, wherein apertures 6376 can be formed in the sheet 6375 during the injection molding process and/or after the injection molding process utilizing a stamping process, for example. In either event, the caps 6370 can be inserted into and secured in the apertures 6376 utilizing a press-fit and/or snap-fit interconnection and/or at least one adhesive. In certain embodiments, each cap 6370 can comprise an annular groove surrounding, or at least partially surrounding, the perimeter of the cap 6370 which can be configured to receive the perimeter of an aperture 6376 therein. In certain embodiments, the sheet 6375 can be comprised of a flexible and/or pliable material which can permit relative movement between the caps 6370. In at least one such embodiment, the flexible sheet 6375 can be comprised of a rubber, plastic, and/or silicone material, for example, and the caps 6370 can be comprised of a rigid material, such as metal, for example. In at least one such embodiment, similar to the above, the flexible material can be molded around the caps 6370. In certain embodiments, the caps 6370 can be pressed into a pre-molded sheet 6375, for example. In various embodiments, the durometer of the flexible material can be selected to provide a desired stiffness of the sheet 6375. In certain embodiments, the sheet 6375 can be configured such that it comprises a flexible band. In any event, the sheet 6375 can facilitate the assembly of the caps 6370 into an end effector as a plurality of the caps 6370 can be positioned and/or aligned simultaneously within the end effector. Furthermore, the sheet 6375 connecting the caps 6370, once implanted, can strengthen or bolster the tissue along the staple line, for example. In addition to or in lieu of a sheet connecting the caps 6370, the caps 6370 can be connected together by a plurality of links. In at least one such embodiment, such links can be flexible and can permit relative movement between the caps 6370.

In various embodiments, referring now to FIGS. 204 and 205, a protective cap, such as cap 6470, for example, can comprise a forming surface which can be configured to deform a tip of a staple leg. In at least one such embodiment, the cap 6470 can comprise a base 6472 which can include an aperture 6471 extending therethrough. In various embodiments, the aperture 6471 can be configured to closely receive a staple leg, such as a staple leg 6221, for example, therein. In at least one embodiment, the aperture 6471 can be defined by a diameter or perimeter which can be equal to or larger than the diameter or perimeter of the staple leg 6221. In various embodiments, the cap 6470 can further comprise a cavity, or dome, 6474 which can be configured to receive the tip of the staple leg 6221 as it is inserted into the cap 6470. Referring primarily to FIG. 205, the cap 6470 can further comprise an anvil, or forming surface, 6473 which can be configured to deflect and deform the staple leg 6221. In various circumstances, the forming surface 6473 can be curved and/or concave, for example, and can be configured to curl the staple leg 6221 as it is inserted into the cap 6470. In certain embodiments, the staple leg 6221 can be sufficiently deformed such that it cannot be withdrawn through the aperture 6471 and, as a result, the cap 6470 can become locked to the staple leg 6221. In at least one such embodiment, the base 6472 of the cap 6470 can define a lip extending around the aperture 6471 which can prevent the deformed staple leg 6221 from being removed from the cavity 6474. In various circumstances, as a result of the above, one or more caps 6470 can prevent, or inhibit, a retention matrix, such as retention matrix 6250, for example, from backing up or being disengaged from the staples 6220. In various embodiments, although not illustrated, the cap 6470 can be symmetrically, or at least substantially symmetrically, formed, and the aperture 6471 can be located along a central axis 6479 extending through the cap 6470. In various alternative embodiments, referring again to FIG. 204, the aperture 6471 can be offset with respect to the central axis 6479. In at least one such embodiment, the offset aperture 6471 can allow the staple leg 6221 to contact a side of the forming surface 6473 and curl over to the other side of the forming surface 6473 instead of contacting the center of the forming surface 6473, as may occur in embodiments comprising a centered aperture 6471 mentioned above.

In various embodiments, as discussed above, a retention matrix, such as retention matrix 6250, for example, can be comprised of a sheet of material and a plurality of retention apertures 6252 extending therethrough. In at least some embodiments, the sheet of material comprising the retention matrix 6250 can be rigid or substantially inflexible. In certain other embodiments, a retention matrix can be comprised of an array of retention matrix elements and a plurality of flexible connectors, or links, connecting the retention matrix elements. In various embodiments, referring now to FIG. 206, a retention matrix, or a portion of retention matrix, 6550 can comprise a plurality of element bodies 6505 which can be connected together by one or more connecting links 6507. In at least one embodiment, each element body 6505 can comprise a plurality of deformable members 6553 which define a retention aperture 6552 therein. In certain embodiments, the element bodies 6505 and the connecting links 6507 of a retention matrix 6550 can be integrally formed and can comprise a unitary piece of material. In various embodiments, the retention matrix 6550 can be stamped or cast, for example, from a metal material, such as titanium and/or stainless steel, for example. In at least one embodiment, the retention matrix 6550 can be comprised of plastic, such as polyetheretherketone (PEEK), polypropylene which is marketed under the trade name Prolene, polyester, polyethylene terephthalate which is marketed under the trade names Ethibond and Mersilene, polyvinylidene fluoride, polyvinylidene fluoride-co-hexafluoropropylene, poly hexafluoropropylene-VDF which is marketed under the trade name Pronova, and/or long-chain aliphatic polymers Nylon 6 and Nylon 6,6 which are marketed under the trade names Ethilon & Nurolon, for example, and can be formed by an injection molding process, for example. In certain embodiments, the element bodies 6505 may not be integrally formed with the connecting links 6507. In various embodiments, a plurality of singular element bodies 6505 can be produced which are subsequently connected together and embedded in a retention matrix. In at least one such embodiment, the element bodies 6505 can be stamped from a metal material, such as titanium and/or stainless steel, for example, and placed in a plastic injection mold wherein a plastic material can be injected into the mold to form, one, a rim 6506 of material surrounding, or at least partially surrounding, the element bodies 6505 and, two, connecting links 6507 extending from the rims 6506. In certain other embodiments, one or more connector lattices can be formed comprising apertures defined within a plurality of rims 6506 wherein each such aperture can be configured to receive an element body 6505 therein. In at least one embodiment, each element body 6505 can comprise a circular, or at least substantially circular, outer perimeter and, similarly, each rim 6506 can define a circular, or at least substantially circular, aperture therein, wherein the diameter of the aperture can be equal to or smaller than the diameter of the element body 6505. In at least one such embodiment, the element bodies 6505 can be press-fit or embedded into the apertures in the rims 6505. In certain embodiments, the element bodies 6505 can be secured in the apertures utilizing at least one adhesive.

In various embodiments, further to the above, a retention matrix can comprise a plurality of element bodies 6505 and a plurality of connecting links 6507 which can connect the element bodies 6505 in any suitable array, such as those illustrated in FIGS. 207-210, for example. Regardless of the pattern of the array, in various embodiments, the connecting links 6507 can be configured to allow the element bodies 6505 and the retention apertures 6552 to move relative to one another. In at least one such embodiment, the lattice of element bodies 6505 and connecting links 6507 comprising the retention matrix 6550, once engaged with tissue, can be configured to stretch, twist, contract, and/or otherwise flex in order to permit at least some movement within the tissue yet, at the same time, resist larger movements thereof. In various embodiments, each connecting link 6507 can comprise a flexible member configured to stretch, twist, and/or contract in order to permit the retention matrix 6550 to flex intermediate the matrix retention elements 6505, for example. Referring again to FIG. 206, each link 6507 extending from a rim 6506 can be defined by a width which is narrower than the width of the element body 6505 and/or the rim 6506. In certain embodiments, referring to FIGS. 207-210, one or more links 6507 can comprise straight portions which extend along a line between adjacent element bodies 6506, for example. In at least one such embodiment, each link 6507 can comprise a first end attached to a first rim 6506 and a second end attached to a second rim 6506. In certain embodiments, referring once again to FIG. 206, two or more links 6507 can be connected to one another. In at least one such embodiment, two or more links 6507 can be connected at an intermediate hinge 6509, for example. In various embodiments, the hinge 6509 can comprise a reduction in cross-sectional thickness in one or more directions as compared to the cross-sectional thickness of the links 6507 which can permit the connected links 6507 to move relative to each other, for example. In certain embodiments, the retention matrix 6550 can further comprise hinges 6508 which can connect the links 6507 to the rims 6506 and permit relative movement between the links 6507 and the rims 6506. Similar to hinges 6509, hinges 6508 can comprise a reduction in cross-sectional thickness in one or more directions as compared to the cross-sectional thickness of the links 6507, for example.

In various embodiments, further to the above, the connected links 6507 can extend in different directions. In at least one such embodiment, a first link 6507 can extend in a first direction and a second link 6507 can extend in a second direction, wherein the first direction can be different than the second direction. In certain embodiments, the first link 6507 can extend along a first line and the second link 6507 can extend along a second line, wherein the first line and the second line can intersect each other at an angle, such as approximately 30 degrees, approximately 45 degrees, approximately 60 degrees, and/or approximately 90 degrees, for example. In various embodiments, the hinges 6508 and/or hinges 6509 can comprise living hinges which can permit the links 6507 to move relative to each other a number of times without breaking. In certain embodiments, the hinges 6508 and/or hinges 6509 can comprise frangible, or easily-breakable, portions which can break when flexed too far and/or flexed too many times. In at least one such embodiment, such frangible portions can permit one or more portions of the retention matrix 6550 to break away from another portion of the retention matrix 6550. In various embodiments, the hinges 6508 and/or hinges 6509, for example, can comprise sections of the retention matrix 6550 which are easier to incise than the other portions of the retention matrix 6550. More particularly, an implanted retention matrix, and the tissue fastened by the implanted retention matrix, may oftentimes by incised by a cutting member for various reasons and, in order to facilitate such cross-cutting, the hinges 6508 and/or hinges 6509 can provide avenues, or thin sections, through which a cutting member can more easily pass through the retention matrix 6550, for example. In various embodiments, further to the above, the connecting links 6507 can comprise one or more coined features or material upsets, for example, defined therein which can facilitate the bending, breakage, and/or incision of the connecting links 6507.

In various embodiments, a retention matrix can comprise a plurality of retention matrix elements, such as matrix element bodies 6505, for example, which can be embedded in a flexible sheet, or band, of material. In at least one embodiment, a flexible sheet of material can be formed from a bioabsorbable, elastomeric material, such as silicone, for example, wherein the flexible sheet can be produced with a plurality of apertures defined therein. In at least one such embodiment, a solid flexible sheet can be molded and a plurality of apertures can be punched out of the flexible sheet. In various alternative embodiments, the flexible sheet can be molded and the apertures defined therein can be formed during the molding process. In either event, the retention matrix elements 6505, for example, can be inserted into and retained within the flexible sheet. In certain other embodiments, similar to the above, the flexible sheet can be formed around the matrix elements 6505. In at least one embodiment, the flexible sheet can be comprised of a woven mesh, for example, and/or any other suitable material. Such a woven mesh, further to the above, may be easy to cross-cut.

In various embodiments, referring now to FIGS. 211 and 212, a fastener system comprising a retention matrix, such as retention matrix 6250, for example, can further comprise a cover, such as cover 6670, for example, which can cover the tips of the staple legs 6221 when they extend above the top surface 6257 of the retention matrix 6250. In various embodiments, the cover 6670 can be attached to the retention matrix 6250. In certain embodiments, the cover 6670 and/or the retention matrix 6250 can comprise retention features which can be configured to retain the cover 6670 to the retention matrix 6250. In at least one embodiment, at least one adhesive can be utilized to adhere the cover 6670 to the retention matrix 6250. In at least one embodiment, the cover 6670 can be comprised of a single layer, although the cover 6670 is illustrated as comprising two layers as described in greater detail further below. In various embodiments, referring primarily to FIG. 212, the tips of the staple legs 6221 can extend through a bottom surface 6673 of the cover 6670; however, the cover 6670 can comprise a sufficient thickness such that the staple tips do not extend through the top surface 6675 of the cover 6670. In at least one such embodiment, as a result, the tips of the staple legs 6221 may not protrude from the cover 6670. In various embodiments, the cover 6670 can comprise a plurality of layers. In at least one such embodiment, the cover 6670 can comprise a first layer 6671 and a second layer 6672. In at least one embodiment, the first layer 6671 and the second layer 6672 can be attached to one another wherein, in at least one embodiment, the second layer 6672 can comprise a bottom surface 6676 which is adhered to the first layer 6671. In various embodiments, the first layer 6671 and the second layer 6672 can comprise different thicknesses while, in certain embodiments, they can comprise the same thickness. In at least one embodiment, the first layer 6671 and the second layer 6672 can comprise substantially the same width and/or length. In alternative embodiments, the layers 6671 and 6672 can comprise different widths and/or lengths.

In various embodiments, further to the above, the first layer 6671 can be comprised of a compressible foam, mesh material, and/or hydrogel, for example, which can be incised by the staple legs 6211. In at least one embodiment, the second layer 6672 can be comprise of a tougher material, or skin, such as PGA and/or PDS, for example, and/or any suitable buttress material. In at least one such embodiment, the staple legs 6221 can be configured to penetrate the first layer 6671; however, in various embodiments, the staple legs 6221 may be unable to penetrate the second layer 6672. In certain embodiments, the second layer 6672 can be comprised of a material having a sufficient resiliency and/or toughness which can permit the second layer 6672 to be contacted and displaced by the staple leg 6221 but not be incised, or only marginally incised, by the staple tip of the staple leg 6221. Although not illustrated, a cover can comprise more than two layers wherein one or more of such layers may be penetration-resistant. In use, in at least one such embodiment, the retention matrix 6250 can be positioned against the tissue to be fastened and pushed downwardly such that the staple legs 6221 of the staples 6220 are pushed through the tissue T and the retention apertures 6252 in the retention matrix 6250 and enter into the first layer 6271 of the cover 6270. In various embodiments, the tips of the staple legs 6221 may not enter, or at least substantially enter, into the second layer 6272 of the cover 6270. After the retention matrix 6250 has been suitably positioned, the jaw 6240 can be opened and the cover 6670 and the retention matrix 6250 can detach from the jaw 6240 as illustrated in FIG. 211. As illustrated in FIG. 211, a jaw 6640 can be configured to hold more than one retention matrix 6250 and cover 6670. In at least one such embodiment, the jaw 6640 can comprise two channels 6679 which each can be configured to receive a cover 6670 therein and a retention matrix 6250 positioned thereover such that the tissue-contacting surface 6251 of each retention matrix 6250 depends downwardly from the bottom of the jaw 6240. In at least one such embodiment, a retention matrix 6250 and a cover 6270 can be housed in the jaw 6640 on each side of a knife slot 6678. In use, both retention matrices 6250 and covers 6670 can be deployed simultaneously and/or to the same depth with respect to opposing staple cartridges, such as cartridges 6200, for example, positioned thereacross. Thereafter, in various embodiments, the fastened tissue can be incised along a cutting line by a cutting member that traverses the knife slot 6678 wherein the jaw 6640 can then be re-opened. In certain embodiments, the covers 6670 may not be attached to the retention matrix 6250. In at least one such embodiment, the covers 6670 can be positioned in the channels 6679 and can be retained in the channels 6679 by the retention matrices 6250 which can be secured to the jaw 6640. In various embodiments, the each retention matrix 6250 can be wider and/or longer than their respective covers 6670 such that the retention matrices 6250 can retain the entirety of their covers 6670 in position. In certain embodiments, each retention matrix 6250 can comprise the same width and/or length as their respective cover 6670, for example.

In various embodiments, as described above, a fastener system can comprise a layer of material which can be attached to a retention matrix, such as retention matrix 6250, for example. In at least one embodiment, referring now to FIG. 215, a layer of material 6870 can be attached to the bottom surface 6251 of the retention matrix 6250. In certain embodiments, the layer 6870 and/or the retention matrix 6250 can comprise retention features which can be configured to retain the layer 6870 to the retention matrix 6250. In at least one embodiment, at least one adhesive can be utilized to adhere the layer 6870 to the retention matrix 6250. In any event, the layer 6870 can comprise a bottom, or tissue-contacting, surface 6873 which can be configured to contact the tissue T when the retention matrix 6250 is moved downwardly toward the staples 6220 to engage the retention apertures 6252 with the staple legs 6221. In at least one such embodiment, the layer 6870 can be comprised of a compressible material, such as a bioabsorbable foam, for example, which can be compressed between the bottom surface 6251 of the retention matrix 6250 and the tissue T. In various embodiments, the layer 6870 can further comprise at least one medicament stored and/or absorbed therein which can be expressed from the layer 6870 as the layer 6870 is compressed. In at least one embodiment, the medicament can comprise at least one tissue sealant, hemostatic agent, and/or anti-microbial material, such as ionized silver and/or triclosan, for example. In various embodiments, the compression of the layer 6870 can squeeze the medicament from the layer 6870 such that the entirety of, or at least a significant portion of, the surface of the tissue T is covered with the medicament. Furthermore, as the layer 6870 is compressed and the staple legs 6221 penetrate the tissue T and the layer 6870, the medicament can flow down the staple legs 6221 and treat the tissue that has just been incised by the staple legs 6221, for example. In various embodiments, the body of the retention matrix 6250 can comprise a first layer which is comprised of a biocompatible material, such as titanium and/or stainless steel, for example, and the bottom layer 6870 can comprise a second layer comprised of a bioabsorbable material, such as oxidized regenerated cellulose (ORC), biologically active agents like fibrin and/or thrombin (either in their liquid state or freeze dried), glycerin, absorbable porcine gelatin in either flue or foam configurations, and/or anti-microbials, such as ionized silver and/or triclosan, for example. Additional bioabsorbable materials can comprise Surgicel Nu-Knit, Surgicel Fibrillar, collagen/ORC which is a hybrid with a built in collagen matrix and is marketed under the trade name Promogran, polyglycolic acid (PGA) which is marketed under the trade name Vicryl, polylactic acid (PLA or PLLA), polydioxanone (PDS), polyhydroxyalkanoate (PHA), poliglecaprone 25 (PGCL) which is marketed under the trade name Monocryl, polycaprolactone (PCL), and/or a composite of PGA, PLA, PDS, PHA, PGCL and/or PCL, for example. Although only one layer 6870 is illustrated in FIG. 215, any suitable number of layers could be used. In at least one embodiment, a first layer comprising a first medicament could be attached to the retention matrix 6250 and a second layer comprising a second, or different, medicament could be attached to the first layer. In at least one such embodiment, a plurality of layers could be used wherein each layer can comprise a different medicament and/or a different combination of medicaments contained therein.

In various embodiments, referring now to FIG. 213, a fastener system can comprise a layer of material 6770 attached to the bottom surface 6251 of the retention matrix 6250. In certain embodiments, the layer 6770 and/or the retention matrix 6250 can comprise retention features which can be configured to retain the layer 6770 to the retention matrix 6250. In at least one embodiment, at least one adhesive can be utilized to adhere the layer 6770 to the retention matrix 6250. In any event, the layer 6770 can comprise a bottom, or tissue-contacting, surface 6773 which can be configured to contact the tissue T when the retention matrix 6250 is moved downwardly toward the staples 6220 to engage the retention apertures 6252 with the staple legs 6221. In at least one such embodiment, the layer 6770 can be comprised of a compressible material, such as a bioabsorbable foam, for example, which can be compressed between the surface 6251 of the retention matrix 6250 and the tissue T. In various embodiments, the layer 6770 can further comprise one or more encapsulations, or cells, 6774 which can be configured to store at least one medicament therein. In certain embodiments, referring to FIG. 214, the encapsulations 6774 can be aligned, or at least substantially aligned, with the retention apertures 6252 such that, when the staple legs 6221 are pushed through the tissue T and the layer 6770, the staple legs 6221 can puncture and/or otherwise rupture the encapsulations 6774. After the encapsulations 6774 have been ruptured, the at least one medicament M stored in the encapsulations 6774 can flow out onto the tissue T. In at least one such embodiment, the medicament M can comprise a fluid which can flow or wick down the staple legs 6221 and treat the tissue T that was just incised by the staple legs. As a result of the above, the medicament stored within the encapsulations 6774 can provide a localized treatment to the tissue. In certain embodiments, the encapsulations 6774 in the sheet 6770 can comprise different medicaments stored therein. For example, a first group of encapsulations 6774 can comprise a first medicament, or a first combination of medicaments, stored therein and a second group of encapsulations can comprise a different medicament, or a different combination of medicaments, stored therein. In various embodiments, the layer 6770 can be comprised of a flexible silicone sheet and the encapsulations 6774 can represent voids in the silicone sheet. In at least one such embodiment, the silicone sheet can comprise two layers that can be attached to one another wherein the encapsulations 6774 can be defined between the two layers. In various embodiments, the layer 6770 can comprise one or more thin sections or weakened portions, such as partial perforations, for example, which can facilitate the incision of the layer 6770 and the rupture of the encapsulations 6774 by the legs 6221. In certain embodiments, at least a portion of the encapsulations 6774 can be positioned within domes 6777, wherein the domes 6777 can extend upwardly from the sheet 6770. In at least one such embodiment, the domes 6777 and/or at least a portion of the encapsulations 6774 can be positioned within the pockets 6201 formed within the retention matrix 6250. In certain embodiments, the encapsulations 6774 may comprise discrete cells which are unconnected to each other. In certain other embodiments, one or more of the encapsulations 6774 can be in fluid communication with each other via one or more passageways, conduits, and/or channels, for example, extending through the layer 6770. The disclosure of U.S. Pat. No. 7,780,685, entitled ADHESIVE AND MECHANICAL FASTENER, which issued on Aug. 24, 2010, is hereby incorporated by reference in its entirety.

In various embodiments, further to the above, a staple cartridge comprising a cartridge body, staples, and/or an alignment matrix therein can be loaded into a first jaw of an end effector and, similarly, a retention matrix and/or one or more covers can be loaded into a second jaw of the end effector. In certain embodiments, referring now to FIG. 216, an instrument, such as cartridge loader 6990, for example, can be used to insert two or more fastener cartridges into an end effector at the same. In at least one embodiment, the cartridge loader 6990 can comprise a handle 6991 and a cartridge carrier 6992, wherein the cartridge carrier 6992 can comprise a first retention portion configured to retain the cartridge body 6210 of the staple cartridge 6200 thereto and, in addition, a second retention portion configured to retain a cartridge body 6980 which supports, one, a plurality of protective caps 6270 therein and, two, a retention matrix 6250 along the bottom surface thereof, for example. In various embodiments, the first and second retention portions can each comprise one or more retention members configured to releasably engage the cartridge bodies 6210 and 6980. In use, referring now to FIGS. 217 and 218, an end effector can comprise a first, or bottom, jaw 6230 and a second, or top, jaw 6940, wherein the staple cartridge 6200 can be loaded into the first jaw 6230 and the cartridge body 6980 can be loaded into the second jaw 6940. In various circumstances, the top jaw 6940 can be rotated from an open position (FIG. 217) to a closed position (FIG. 218) by an actuator 6235, wherein the operation of the actuator 6235 is described above and is not repeated herein for the sake of brevity. Once the top jaw 6940 is in its closed position, referring now to FIG. 218, the distal end 6993 of the cartridge carrier 6992 can be inserted into the end effector such that the staple cartridge 6200 is slid through the distal end 6938 of the first jaw 6930 and into a first attachment portion, or channel, 6939 in the first jaw 6230. Similarly, the distal end 6993 of the cartridge carrier 6992 can be inserted into the end effector such that the cartridge body 6980 is slid through the distal end 6948 of the second jaw 6940 and into a second attachment portion, or channel, 6949 in the second jaw 6940. A surgeon, or other clinician, holding the handle 6991 of the cartridge loader 6990 can push the staple cartridge 6200 and the cartridge body 6980 through the channels 6939 and 6949, respectively, until the staple cartridge 6200 and the cartridge body 6980 are fully seated therein.

As the staple cartridge 6200 and the cartridge body 6980 are being seated, the staple cartridge 6200 and the cartridge body 6980 can each engage one or more retention portions in their respective jaws 6230 and 6940, as described in greater detail further below. In any event, once the staple cartridge 6200 and the cartridge body 6980 have been seated, referring now to FIG. 219, the cartridge loader 6990 can be detached from the staple cartridge 6200 and the cartridge body 6980 and removed from the end effector. In at least one such embodiment, the retention force holding the staple cartridge 6200 in the first jaw 6230 can be greater than the retention force holding the staple cartridge 6200 to the cartridge carrier 6992 such that, as the cartridge carrier 6992 is pulled distally out of the end effector, the staple cartridge 6200 can remain behind in the first jaw 6230. Similarly, the retention force holding the cartridge body 6980 in the second jaw 6940 can be greater than the retention force holding the cartridge body 6940 to the cartridge carrier 6992 such that, as the cartridge carrier 6992 is pulled distally out of the end effector, the cartridge body 6940 can remain behind in the second jaw 6940. Once the cartridge loader 6990 has been removed from the end effector, the loaded first jaw 6230 and the loaded second jaw 6940 can be positioned relative to the tissue T that is to be stapled. Referring now to FIG. 220, the second jaw 6940 can be moved from an open position (FIG. 219) to a fired position (FIG. 220) in order to engage the retention matrix 6250 and the plurality of protective caps 6270 carried by the cartridge body 6980 with the staples 6220 positioned within the staple cartridge 6200.

Referring now to FIGS. 221 and 222, the second jaw 6940 can be re-opened and the plurality of protective caps 6270 and the retention matrix 6250 can detach from the cartridge body 6980 such that the caps 6270 and the retention matrix 6250 can remain engaged with the tissue T and the staple cartridge 6200. In at least one embodiment, the cartridge body 6980 can comprise a plurality of pockets in which the plurality of caps 6270 can be removably positioned and one or more retention slots configured to removably retain the retention matrix 6250 thereto. In various embodiments, the retention members of the second jaw 6940 engaged with the cartridge body 6980 can retain the cartridge body 6980 in the second jaw 6940 after the second jaw 6940 has been opened. In certain embodiments, the cartridge body 6980 can be configured to tear as the second jaw 6940 is opened such that a portion of the cartridge body 6980 is implanted with the caps 6270 and the retention matrix 6250 and a portion of the cartridge body 6980 remains in the second jaw 6940. Similarly, referring again to FIGS. 221 and 222, the retention members of the first jaw 6230 engaged with the cartridge body 6210 can retain the cartridge body 6210 in the first jaw 6230 after the second jaw 6940 has been opened. In certain embodiments, the cartridge body 6210 can be configured to tear as the first jaw 6230 is pulled away from the implanted cartridge 6200 such that a portion of the cartridge body 6210 is implanted with the staples 6220 and alignment matrix 6260 and a portion of the cartridge body 6210 remains in the first jaw 6230. In various embodiments, referring now to FIGS. 223-225, a staple cartridge, such as staple cartridge 6900, for example, can comprise one or more longitudinal retention slots 6913 extending along the length of the cartridge body 6910 which, when the staple cartridge 6900 is inserted into a jaw 6930, for example, can be configured to receive one or more longitudinal retention rails 6916 extending from the jaw 6930 therein. In use, in at least one embodiment, an end of the retention slots 6913 can be aligned with the distal ends of the retention rails 6916 before the staple cartridge 6900 is slid through the distal end 6938 of the retention channel 6939, for example.

In various embodiments, referring again to FIG. 225, the jaw 6940 can comprise two retention channels 6949, wherein each retention channel 6949 can be configured to receive a cartridge body 6980 comprising a plurality of caps 6270 and a retention matrix 6250 therein. In certain embodiments, each cartridge body 6980 can comprise one or more longitudinal retention shoulders 6917 which can be configured to be slid along one or more longitudinal retention rails 6918 of the second jaw 6940 as the cartridge bodies 6980 are inserted into their respective retention channels 6949 in jaw 6940. In various embodiments, the retention rails 6918 and the retention shoulders 6917 can co-operate to retain the cartridge body 6980 in the second jaw 6940 as the cartridge bodies 6980 are detached from the caps 6270 and the retention matrix 6250 stored therein. In various embodiments, referring now to FIG. 224, the second jaw 6940 can further comprise one or more distal bumps, or retention members, 6915 extending therefrom which can be configured to removably lock the cartridge bodies 6980 in their respective retention channels. In at least one such embodiment, the second jaw 6940 can comprise a distal bump 6915 configured and positioned relative to each retention channel 6949 such that each cartridge body 6980 can flex around the bumps 6915 as the cartridge bodies 6980 are being inserted into the channels 6949 wherein, just as the cartridge bodies 6915 are being fully seated in the channels 6949, the distal ends of the cartridge bodies 6980 can clear and snap over the bumps 6915. In order to remove the cartridge bodies 6980 after they have been expended, as described above, the cartridge bodies 6980 can be pulled back over the bumps 6915 and removed from the retention channels 6949. Similar to the above, the first jaw 6930 can comprise one or more distal retention bumps 6914 extending therefrom which can be configured to be received in one or more retention grooves, or slots, 6912 (FIG. 223) in the cartridge body 6910 when the staple cartridge 6900 has been fully seated.

In various embodiments, further to the above, a first fastener cartridge comprising a plurality of first fasteners positioned therein can be positioned in a first jaw of a surgical fastening device and a second fastener cartridge comprising a plurality of second fasteners positioned therein can be positioned in a second jaw of the surgical fastening device. In use, the first jaw and/or the second jaw can be moved toward the other in order to engage the first fasteners with the second fasteners and secure tissue therebetween. In certain embodiments, the first fastener cartridge and the second fastener cartridge can be engaged with each other as the first fasteners are engaged with the second fasteners. In at least one embodiment, the body of the first fastener cartridge can be comprised of a first compressible material and the body of the second fastener cartridge can be comprised of a second compressible material, wherein the first body and/or the second body can be compressed against the tissue being fastened. After the tissue has been fastened, the first jaw can be moved away from the implanted first fastener cartridge and the second jaw can be moved away from the implanted second fastener cartridge. Thereafter, the first jaw can be reloaded with another first fastener cartridge, or the like, and the second jaw can be reloaded with another second fastener cartridge, or the like, and the surgical fastening instrument can be reused. While staples can be used in some embodiments, other embodiments are envisioned comprising other types of fasteners, such as two-part fasteners which are locked together when they are engaged with one another, for example. In at least one such embodiment, the first fastener cartridge can comprise a first storage portion for storing the first fastener portions and the second fastener cartridge can comprise a second storage portion for storing the second fastener portions. In various embodiments, the fastening systems described herein can utilize fasteners comprising any suitable type of material and/or form. In certain embodiments, the fasteners can comprise penetrating members. Such penetrating members could be comprised of a polymer, a composite, and/or a multi-layered substrate, for example. An example of a multi-layered substrate could be a wire or a sheet substrate with an elastomeric or polymeric coating. It could be a thin sheet formed such that penetrating members are oriented perpendicular, or at least substantially perpendicular, to the connecting member. The penetrating members could comprise a rectangular profile, semi-circular profile, and/or any beam profile. In various embodiments, the fasteners described herein can be manufactured utilizing any suitable process, such as a wire extruding process, for example. Another possibility is the use of microfabrication to create hollow penetrating members. These penetrating members could be fabricated from a process which is different than a wire extruded process and could use a combination of materials.

As described above, the tips of staple legs protruding through a retention matrix can be covered by one or more caps and/or covers. In certain embodiments, the tips of the staple legs can be deformed after they have been inserted through the retention matrix. In at least one embodiment, a jaw holding the retention matrix can further comprise anvil pockets positioned above and/or aligned with the retention apertures which can be configured to deform the staple legs as they protrude above the retention matrix. In various embodiments, the staple legs of each staple can be curled inwardly toward each other and/or toward the center of the staple, for example. In certain other embodiments, one or more of the staple legs of a staple can be curled outwardly away from the other staple legs and/or away from the center of the staple. In various embodiments, regardless of the direction in which the staple legs are curled, the tips of the staple legs can contact the body of the retention matrix and may not re-enter the tissue that has been fastened by the staples. In at least one embodiment, the deformation of the staple legs after they have passed through the retention matrix can lock the retention matrix in position.

In various embodiments, referring now to FIGS. 226 and 227, a surgical stapling instrument, such as surgical stapler 7000, for example, can comprise a first jaw 7030 and a second jaw 7040, wherein the second jaw 7040 can be moved toward and away from the first jaw 7030 by the movement of actuator 6235. The operation of actuator 6235 is described above and is not repeated herein for the sake of brevity. In various embodiments, the first jaw 7030 can comprise a distal end 7031 and a proximal end 7032, wherein the first jaw 7030 can define a channel extending between the distal end 7031 and the proximal end 7032 which is configured to receive a staple cartridge. For the purposes of illustration, the cartridge body of such a staple cartridge is not depicted in FIG. 226, although such a staple cartridge can comprise a cartridge body, staples 6220 positioned within the cartridge body, and staple drivers 7012 positioned underneath the staples 6220. In certain embodiments, although not illustrated in FIG. 226 for the sake of clarity, the second jaw 7040 can be configured to hold a retention matrix, such as retention matrix 6250, for example, over the staples 6220 and/or move the retention matrix into engagement with the legs of the staples 6220 as described above. In at least one embodiment, the surgical stapler 7000 can further comprise a sled 7010 positioned in the first jaw 7030 which can be slid from the distal end 7031 of the first jaw 7030 toward the proximal end 7032, for example, and lift the staple drivers 7012, and the staple 6220 supported thereon, toward the retention matrix and the second jaw 7040. In various other embodiments, the sled 7010 can be moved from the proximal end 7032 toward the distal end 7031 in order to deploy the staples 6020, for example. In at least one embodiment, the sled 7010 can comprise one or more inclined ramps, or cams, 7011 which can be configured to slide underneath the staple drivers 7012 and lift the staple drivers 7012 upwardly. In various embodiments, the surgical stapler 7000 can further comprise a pull, or push, rod operably coupled to the sled 7010 which can be moved proximally and/or distally by an actuator located on a handle and/or shaft of the surgical stapler 7000, for example.

In various embodiments, referring again to FIG. 226, the second jaw 7040 of the surgical stapler 7000 can comprise a frame 7041, a distal end 7048, and a proximal end 7049 positioned opposite the distal end 7048. In certain embodiments, the second jaw 7040 can further comprise a guide system comprising one or more guide rails, such as guide rails 7045 and 7046, for example, extending along the longitudinal axis of the frame 7041 which, as described in greater detail further below, can be configured to guide one or more anvils, or cams, which can engage and deform the staple legs of the staples 6220 after the staple legs 6221 of the staples 6220 have passed through the retention matrix. In at least one such embodiment, the guide rails 7045 and 7046 can comprise a guide wire or cable which extends along a top portion or surface of the frame 7041, around a distal post 7047, and back along the top portion or surface of the frame 7041, for example. In various embodiments, as mentioned above and referring primarily now to FIGS. 228 and 230, the second jaw 7040 can further comprise one or more anvils, or cams, such as first anvil 7050 and second anvil 7060, for example, which can be moved longitudinally along the second jaw 7040 in order to deform the legs of the staples 6220 after they have passed through the retention matrix. In at least one embodiment, the surgical stapler 7000 can further comprise a first anvil driver, or actuator, 7051 connected to and/or operably coupled to the first anvil 7050 which can be configured to pull the first anvil 7050 proximally and/or push the first anvil 7050 distally. Similarly, in at least one embodiment, the surgical stapler 7000 can further comprise a second anvil driver, or actuator, connected to and/or operably coupled to the second anvil 7060 which can be configured to push the second anvil 7060 distally and/or pull the second anvil 7060 proximally. In various embodiments, the first anvil 7050 can comprise guide slots 7052 and the second anvil 7060 can comprise guide slots 7062 which can each be configured to slidably receive guide rail 7045 or guide rail 7046 therein. In at least one such embodiment, the guide rails 7045 and 7046 can be closely received within the guide slots 7052 and 7062 such that relative lateral, or side-to-side, movement therebetween can be prevented, or at least limited.

In certain embodiments, further to the above, the first anvil 7050 can be pulled proximally and the second anvil 7060 can be pulled distally. In at least one embodiment, referring to FIG. 226, the guide rails 7045 and 7046 and the distal post 7047 can comprise a pulley system configured to pull the second anvil 7060 distally and/or pull the second anvil 7060 proximally. In at least one such embodiment, the guide rail 7045 and the guide rail 7046 can comprise a continuous wire or cable extending around the distal post 7047, wherein a portion of the continuous wire can be pulled in order to cycle the wire around the distal post 7047. In various embodiments, the guide rail 7046, for example, can be mounted to the second anvil 7060 such that, when the continuous cable is cycled in a first direction, the second anvil 7060 can be pulled distally toward the distal end 7048 of the jaw 7040 and, when the continuous cable is cycled in a second, or opposite, direction, the second anvil 7060 can be pulled proximally toward the proximal end 7049. In at least one embodiment, referring now to FIG. 228, the guide rail 7046 can be secured within a guide slot 7062 such that a pulling force can be transmitted therebetween. In at least one such embodiment, the guide rail 7045 can be configured to slide within the other guide slot 7062. In various embodiments, the first anvil 7050 may operate independently of the second anvil 7060 and the pulley system and the guide slots 7052 defined in the first anvil 7050 may be configured to slidably receive the guide rails 7045 and 7046 such that relative movement is permitted therebetween. In various embodiments, the continuous cable comprising guide rails 7045 and 7046 can be sufficiently flexible in order to accommodate the opening and closing of the top jaw 7040. The continuous cable can also be sufficiently flexible in order to accommodate the vertical movement of the second anvil 7060 toward and away from the bottom jaw 7030, which is described in greater detail further below.

In various embodiments, referring again to FIGS. 228 and 230, the first anvil 7050 can comprise cam followers 7055 extending therefrom which can be configured to ride in one or more cam slots, or guide slots, such as cam slot 7070 (FIG. 231), for example, defined in the frame 7041 of the second jaw 7040. More particularly, in at least one embodiment, the frame 7041 can comprise a first cam slot 7070 extending longitudinally along a first side of the frame 7041 and a second cam 7070 extending longitudinally along a second, or opposite, side of the frame 7041, wherein the cam followers 7055 extending from a first side of the first anvil 7050 can ride in the first cam slot 7070 and the cam followers 7055 extending from a second side of the first anvil 7050 can ride in the second cam slot 7070. In at least one such embodiment, the contours of each cam slot 7070 can be identical, or at least substantially identical, and can be aligned, or at least substantially aligned, with one another. Similarly, in various embodiments, the second anvil 7060 can comprise cam followers 7065 extending therefrom which can be configured to ride in the cam slots 7070 (FIG. 231) defined in the frame 7041 of the second jaw 7040. More particularly, in at least one embodiment, the cam followers 7065 extending from a first side of the second anvil 7060 can ride in the first cam slot 7070 and the cam followers 7065 extending from a second side of the second anvil 7060 can ride in the second cam slot 7070. In use, the cam followers 7055 of the first anvil 7050 and the cam followers 7065 of the second anvil 7060 can slide within the cam slots 7070 such that first anvil 7050 and the second anvil 7060 follow the contours of the cam slots 7070 as the first anvil 7050 and the second anvil 7060 are pulled proximally and/or pushed distally. In various embodiments, each cam slot 7070 can comprise a plurality of dwell, or upper, portions 7071 and a plurality of driver, or lower, portions 7072 which can be configured to move the anvils 7050 and 7060 vertically, i.e., toward and away from the bottom jaw 7030, at the same time that the anvils 7050 and 7060 are being moved longitudinally, i.e., between the distal end 7048 and the proximal end 7049 of the frame 7041, as described in greater detail further below.

When the surgical stapler 7000 is in an unfired condition, referring to FIG. 231, the first anvil 7050 can be positioned at the distal end 7048 of the frame 7041 and the second anvil 7060 can be positioned at the proximal end 7049 of the frame 7041; furthermore, referring now to FIG. 232, the staples 6220 positioned in the first jaw 7030 may not yet be inserted into the tissue T and/or the retention matrix positioned thereabove when the surgical stapler 7000 is in an unfired condition. In use, referring now to FIG. 233, the staples 6220 can be driven upwardly within the staple cavities 7033 of a staple cartridge by the staple drivers 7012 and, in addition, the first anvil 7050 can be moved proximally from the distal end 7048 of the frame 7041 toward the distal end 7049 in order to engage the staple legs 6221 of the staples 6220. In at least one embodiment, the staples 6220 can be driven upwardly before the first anvil 7050 is engaged with the staple legs 6221 thereof. In various embodiments, all of the staples 6220 may be deployed upwardly by the sled 7010 before the first anvil 7050 is advanced into contact with the staple legs 6221 or, alternatively, the sled 7010 may be moved proximally at the same time that the first anvil 7050 is moved proximally, although the sled 7010 may sufficiently lead the first anvil 7050 in order to deploy the staples 6220 ahead of the first anvil 7050. In various embodiments, as illustrated in FIG. 233, the cam slots 7070 can be configured and arranged such that the forming surfaces, such as forming, or camming, surfaces 7053 and 7054, for example, of the first cam 7050 can contact at least some of the staple legs 6221 when the first cam 7050 is passing through a dwell, or upper, position. In various circumstances, the cam followers 7055 of the first anvil 7050 can each be positioned in a dwell portion 7071 of the cam slots 7070 such that the forming surfaces 7053 and 7054 are in a raised position and such that the staple legs 6221 are only partially deformed when the anvil 7050 passes thereby in the dwell position. As the first cam 7050 is moved further along the cam slots 7070, as illustrated in FIG. 234, the cam followers 7055 of the first anvil 7050 can be driven into driven, or lower, portions 7072 of the cam slots 7070 such that the forming surfaces 7053 and 7054 are moved vertically downwardly toward the staple legs 6021 in order to drive the staple legs 6021 into their finally formed configurations. Thereafter, as the first anvil 7050 is progressed further along the cam slots 7070, the first anvil 7050 can be driven vertically upwardly into another set of dwell portions 7071 of the cam slots 7070. As illustrated in FIGS. 233 and 234, the reader will note that the first anvil 7050 may only engage some of the staple legs and not others. In at least one such embodiment, the first anvil 7050 can be configured to only deform a group of staple legs comprising the distal staple legs 6221 of the staples 6220, for example. In at least one such embodiment, the first anvil 7050 can be configured to deform the distal staple legs 6221 toward the center of the staples 6220. In various embodiments, each proximal staple leg 6221 can be contacted twice by the first anvil 7050, i.e., by a first forming surface 7053 and by a second forming surface 7054 aligned with the first forming surface 7053. In at least one such embodiment, the first forming surfaces 7053 can deform the distal staple legs 6221 into a partially-deformed configuration when the first anvil 7050 is in a dwell, or upper, position and the second forming surfaces 7054 can deform the distal staple legs 6221 into a fully-formed configuration when the first anvil 7050 is moved into a driven, or lower, position. In various embodiments, referring now to FIGS. 228 and 229, the first anvil 7050 can comprise a plurality of first forming surfaces 7053 and a plurality of second forming surfaces 7054 in order to deform the distal staple legs 6221 of staples 6220 when the staple legs 6221 are arranged in more than one row or line. In various embodiments, as described in greater detail further below, the proximal staple legs 6221 of the staples 6020 can be deformed by the second anvil 7060, for example.

In various embodiments, further to the above, the first anvil 7050 can be moved from the distal end 7048 of the frame 7041 to the proximal end 7049 in order to deform all of the distal staple legs 6221 of the staples 6220. As the reader will note, the first anvil 7050 can be moved up and down relative to the undeformed proximal staple legs 6221 and, in order to accommodate such relative movement, in various embodiments, the first anvil 7050 can comprise one or more clearance slots 7057 (FIG. 230) which can be configured to receive the unbent proximal staple legs 6221 as the first anvil 7050 bends the distal staple legs 6221. Similarly, referring again to FIG. 228, the second anvil 7060 can comprise a clearance slot 7067 which can be configured to accommodate the vertical movement of the first cam actuator 7051 which moves up and down as the first anvil 7050 is moved between its dwell and driven positions as described above. After all of the distal staple legs 6221 have been bent, in at least one embodiment, the second anvil 7060 can be moved from the proximal end 7049 of the frame 7041 to the distal end 7048 by the anvil actuator 7061. Similar to the above, referring now to FIG. 235, the cam followers 7065 of the second anvil 7060 can slide within the cam slots 7070 such that the second anvil 7060 is moved between dwell, or upper, positions and driven, or lower, positions in order to deform the proximal staple legs 6221 inwardly toward the centers of the staples 6220, for example. Similar to the above, the second anvil 7060 can comprise a plurality of first forming, or camming, surfaces 7063 and a plurality of second forming, or camming, surfaces 7064 which can each be configured to at least partially deform and/or completely deform one or more of the proximal staple legs 6021. Referring again to FIG. 229, the second anvil 7060 can comprise a plurality of first forming surface 7063 and a plurality of second forming surfaces 7064 which can be configured to deform the proximal staple legs 6221 of staples 6220 arranged in a plurality of rows, or lines, for example. As also illustrated in FIG. 229, the first forming surfaces 7063 and the second forming surfaces 7064 of the second anvil 7060 may not be aligned with the first forming surfaces 7053 and the second forming surfaces 7054 of the first anvil 7050 wherein, as a result, the proximal legs 6221 of the staples 6220 may be positioned in different rows, or lines, than the distal legs 6221 of the staples 6220. As the reader will also note, the second anvil 7060 can push the first anvil 7050 as the second anvil 7060 is moved distally. In at least one such embodiment, the second anvil 7060 can push the first anvil 7050 back into the distal end 7048 of the frame 7041 such that the first anvil 7050 can be returned to its initial, or unfired, position. After all of the proximal staple legs 6221 of the staples 6220 have been deformed, the second anvil 7060 can be retracted proximally and returned to its initial, or unfired, position. In this way, the surgical stapler 7000 can be reset such that a new staple cartridge can be positioned in the first jaw 7030 and a new retention matrix can be positioned in the second jaw 7040 in order to use the surgical stapler 7000 once again.

In various embodiments, as described above, a surgical stapler can comprise two or more anvils which can travel longitudinally in order to engage the legs of a plurality of staples in a transverse direction. In certain embodiments, a surgical stapler can comprise an anvil which is moved proximally, for example, in order to deform a first group of staple legs and distally, for example, in order to deform a second group of staple legs. In at least one such embodiment, such an anvil can comprise forming surfaces facing proximally and forming surfaces facing distally, for example.

In various embodiments, referring now to FIG. 236, an anvil, such as anvil 7140, for example, can comprise a bottom, or tissue-contacting, surface 7141 and a plurality of forming pockets 7142 defined therein. In at least one embodiment, the anvil 7140 can comprise more than one plate, such as pocket plates 7143, for example, which can be welded into a frame 7144. In at least one such embodiment, each pocket plate 7143 can be positioned in a plate channel 7145 in the frame 7144 and welded to the frame 7144 through a weld slot 7146 extending through the frame 7144 in order to form a longitudinal weld 7147. In various circumstances, the longitudinal weld 7147 can comprise a continuous weld extending along the entire length of the weld slot 7146 or a series of spaced-apart spot welds extending along the length thereof, for example. In various embodiments, each pocket plate 7143 can comprise two or more plate portions that have been welded together. In at least one such embodiment, each pocket plate 7143 can comprise a first plate portion 7143a and a second plate portion 7143b which can be welded together along a seam 7148. In various embodiments, the first plate portion 7143a and the second plate portion 7143b of each plate 7143 can be welded together before the plates 7143 are welded into the plate channels 7145 in the frame 7144. In at least one such embodiment, the first plate portion 7143a and the second plate portion 7143b can comprise co-operating profiles, such as the toothed profiles illustrated in FIG. 236, for example, which can be fitted together to form a tight seam 7148. In at least one embodiment, each plate 7143 can comprise a height of approximately 0.02″, for example, which can be taller than the depth of the plate channels 7145 such that the tissue-contacting surfaces 7141 thereof extend from the frame 7044 of the anvil 7040. In certain embodiments, referring now to FIG. 237, the plates 7143 can be connected together by at least one weld 7149 at the distal ends of the plates 7143, for example.

As illustrated in FIGS. 236 and 237, each pocket plate 7143 can comprise a plurality of forming pockets 7142 defined therein. In various embodiments, the forming pockets 7142 can be formed in the plates 7143 by any suitable manufacturing process, such as a grinding process and/or electrode-burning process, for example. In at least one such embodiment, referring now to FIGS. 238 and 239, each forming pocket 7142 can be manufactured by first forming a deep well 7150, then forming an arcuate or curved surface 7151 surrounding the deep well 7150, and then forming a staple leg guide groove 7152 in the curved surface 7151, for example. In various other embodiments, these steps can be performed in any suitable order. In various embodiments, referring now to FIG. 240, the staple forming pockets 7142 can be formed such that the inner edges 7153 of the forming pockets are separated by a consistent, or at least substantially consistent, gap 7154. In at least one such embodiment, the gap 7154 can be approximately 0.008″, for example. Furthermore, in at least one such embodiment, the forming pockets 7142 can be positioned along two or more rows, or lines, the centerlines of which can be separated by a consistent, or at least substantially consistent, spacing 7155. In at least one such embodiment, the spacing 7155 between the centerlines can be approximately 0.035″, for example. In various embodiments, referring again to FIG. 240, each forming pocket 7142 can taper between a narrow width 7156 and a wide width 7157. In at least one such embodiment, the narrow width 7156 can be approximately 0.045″ and the wide width 7157 can be approximately 0.075″, for example. In various embodiments, the plates 7143 can be comprised of the same material as the frame 7144. In at least one such embodiment, the plates 7143 and the frame 7144 can both be comprised of stainless steel, such as a 300 series or a 400 series stainless steel, for example, and/or titanium, for example. In various other embodiments, the plates 7143 and the frame 7144 can be comprised of different materials. In at least one such embodiment, the plates 7143 can be comprised of a ceramic material, for example, and the frame 7144 can be comprised of a stainless steel and/or titanium, for example. In various circumstances, depending on the materials used, at least one brazing process could be used to secure the plates 7143 in the frame 7144 in addition to or in lieu of the welding processes described above, for example.

In various embodiments, referring now to FIGS. 241-243, an anvil 7240 can comprise a frame 7244 and a plurality of pocket plates 7243 which can be inserted into the frame 7244. Similar to the above, each pocket plate 7243 can comprise a plurality of forming pockets 7242 defined therein. In at least one embodiment, the anvil frame 7244 can comprise retention slots 7246 defined therein which can each be configured to receive a retention rail 7247 extending from a pocket plate 7243. In order to assemble the pocket plates 7243 to the anvil frame 7244, the side walls 7245 of the anvil frame 7244 can be flexed or splayed outwardly, as illustrated in FIG. 242, in order to widen the retention slots 7246 such that each retention slot 7246 can receive a retention rail 7247 of a pocket plate 7243 therein. Once the retention rails 7247 have been positioned in the retention slots 7246, the side walls 7245 can be released, as illustrated in FIG. 243, thereby allowing the frame 7244 to resiliently contract and/or return to its unflexed state. In such circumstances, the retention slots 7246 can contract and thereby capture the retention rails 7247 therein. In certain embodiments, the retention rails 7247 and/or the retention slots 7246 can comprise one or more co-operating tapered surfaces which, after the flexed retention slots 7246 have been released, can form a taper-lock engagement which can retain the retention rails 7247 in the retention slots 7246. Similar to the above, the pocket plates 7243 can be comprised of the same material as or a different material than the frame 7244. In at least one such embodiment, the plates 7243 can be comprised of a ceramic material, for example, and the frame 7244 can be comprised of a stainless steel and/or titanium, for example. In various circumstances, depending on the materials used, at least one brazing process and/or at least one welding process, for example, could be used to secure the plates 7243 in the frame 7244.

In various embodiments, referring to FIGS. 259-262, a staple cartridge, such as staple cartridge 21000, for example, can comprise a cartridge body 21010 including a plurality of staple cavities 21011, a plurality of staples 21030 removably positioned within the staple cavities 21011, and a plurality of staple drivers 21090 which can be configured to eject the staples 21030 from the staple cavities 21011. The staple cartridge 21000 can further include a pan, or retainer, 21070 which can be attached to the cartridge body 21010 to hold the staple drivers 21090 in position. In various embodiments, the retainer 21070 can include one or more lock arms 21071 which can be configured to engage the cartridge body 21010 and/or one or more lock windows 21072 configured to receive one or more protrusions, or bumps, 21018 extending from the cartridge body 21010. In various embodiments, the retainer 21070 and/or the cartridge body 21010 can include one or more features configured to secure the staple cartridge 21000 within a cartridge channel 21040 of a surgical stapler. In use, a sled 21080 can be configured to traverse a longitudinal cavity defined within the cartridge body 21010 in order to lift the staple drivers 21090 and the staples 21030 upwardly toward an anvil, such as anvil 21060, for example, positioned opposite the staple cartridge 21000. In various embodiments, the surgical stapler can further comprise a shaft 21050 including a firing member 21052 which can be advanced longitudinally to engage the sled 21080 and advance the sled 21080 distally. In at least one such embodiment, the shaft 21050 can include an outer housing 21051, an articulation joint 21057, and/or one or more articulation control arms 21059 which can be configured to articulate the end effector of the surgical instrument. Various systems for advancing the outer housing 21051 to close the anvil 20060 and various systems for operating the articulation control arms 21059 are described in a contemporaneously-filed, co-pending U.S. patent application Ser. No. 13/241,629, entitled SURGICAL INSTRUMENT WITH SELECTIVELY ARTICULATABLE END EFFECTOR, now U.S. Patent Application Publication No. 2012/0074200, the entire disclosure of which is incorporated by reference herein.

In various embodiments, referring primarily to FIG. 259, the cartridge body 21010 can be curved. In at least one embodiment, the cartridge body 21010 can be curved with respect to a longitudinal axis, such as longitudinal axis 21019, for example. In at least one such embodiment, the cartridge body 21010 can include a linear proximal portion which can define the longitudinal axis 21019 and an intermediate portion and a distal portion which can curve laterally with respect to the axis 21019, for example. In some embodiments, the proximal portion of the cartridge body 21010 can curve laterally with respect to the longitudinal axis 21019. Referring to FIGS. 259 and 260, the cartridge body 21010 can include a longitudinal slot 21015 defined therein which can be configured to permit a cutting member 21053 of the firing member 21052 to pass therethrough. In at least one embodiment, the longitudinal slot 21015 can define a curved axis and/or centerline of the cartridge body 21010. As illustrated in FIG. 259, the retainer 21070 attached to the cartridge body 21010 can also include a curved longitudinal slot 21075 which can parallel, or at least substantially parallel, the longitudinal slot 21015 defined in the cartridge body 21010. Similarly, the cartridge channel 21040 can include a curved longitudinal slot 21045 which can parallel, or at least substantially parallel, the longitudinal slot 21015 defined in the cartridge body 21010. In various embodiments, referring to FIGS. 259 and 260, the firing member 21052 can be configured to flex or bend as it traverses the slots 21015, 21045, and 21075 when the firing member 21052 is advanced distally through the staple cartridge 21000. In at least one embodiment, the firing member 21052 can include apertures 21054 defined therein which can be configured to permit the firing member 21052 to bend as it passes through the curved cartridge body 21010. In various embodiments, at least a portion of the firing member 21052 can be fabricated such that it is pre-curved, i.e., curved before it is inserted into the cartridge body 21010. In at least one such embodiment, the distal knife portion 21053 of the firing member 21052 can be manufactured such that it is defined by a radius of curvature which is equal to, or at least substantially equal to, the radius of curvature which defines the longitudinal slots 21015, 20145, and 21075.

In various embodiments, the proximal portion, the intermediate portion, and/or the distal portion of the cartridge body 21010 can curve in the same direction or in different directions. In some embodiments, the proximal portion, the intermediate portion, and/or the distal portion of the cartridge body 21010 can be defined along the same radius of curvature or different radiuses or curvature. In various embodiments, referring primarily to FIG. 259, the staple cavities 21011 can be arranged in several curved rows. In at least one embodiment, the cartridge body 21010 can include a first row of staple cavities 21011 arranged along a first radius of curvature 21011a, a second row of staple cavities 21011 arranged along a second radius of curvature 21011b, a third row of staple cavities 21011 arranged along a third radius of curvature 21011c, and/or a fourth row of staple cavities 21011 arranged along a fourth radius of curvature 21011d, for example. In various other embodiments, additional rows of staple cavities are contemplated. Each staple cavity 21011 within the first row of staple cavities 21011 can comprise, or can be defined by, a longitudinal axis which extends between a proximal end and a distal end thereof wherein, as a result of the curved arrangement of the staple cavities 21011 within the first row, the longitudinal axes of the staple cavities 21011 within the first row may not be collinear and may extend at transverse angles with respect to each other. Longitudinal axes 21019a for some of the staple cavities 21011 are illustrated in FIG. 260. Similarly, each staple cavity 21011 within the second row of staple cavities 21011 can comprise, or can be defined by, a longitudinal axis which extends between a proximal end and a distal end thereof wherein, as a result of the curved arrangement of the staple cavities 21011 within the second row, the longitudinal axes of the staple cavities 21011 within the second row may not be collinear and may extend at transverse angles with respect to each other. Also, each staple cavity 21011 within the third row of staple cavities 21011 can comprise, or can be defined by, a longitudinal axis which extends between a proximal end and a distal end thereof wherein, as a result of the curved arrangement of the staple cavities 21011 within the third row, the longitudinal axes of the staple cavities 21011 within the third row may not be collinear and may extend at transverse angles with respect to each other. Furthermore, each staple cavity 21011 within the fourth row of staple cavities 21011 can comprise, or can be defined by, a longitudinal axis which extends between a proximal end and a distal end thereof wherein, as a result of the curved arrangement of the staple cavities 21011 within the fourth row, the longitudinal axes of the staple cavities 21011 within the fourth row may not be collinear and may extend at transverse angles with respect to each other.

Further to the above, the first radius of curvature 21011a which defines the first row of staples 21011 can be larger than the second radius of curvature 21011b which defines the second row of staples 21011. In various embodiments, the second radius of curvature 21011b which defines the second row of staples 21011 can be larger than the radius of curvature which defines the curved longitudinal slot 21015. In at least one such embodiment, the radius of curvature which defines the curved longitudinal slot 21015 can be larger than the radius of curvature 21011c which defines the third row of staples 21011. Similarly, the radius of curvature 21011c which defines the third row of staples 21011 can be larger than the fourth radius of curvature 21011d which defines the fourth row of staples 21011. In various embodiments, referring again to FIG. 259, the staple cartridge 21000 can further include a tissue thickness compensator 21020 which can be positioned above the top deck surface 21012 of the cartridge body 21010. Similar to the above, the tissue thickness compensator 21020 can be retained to the cartridge body 21010 in any suitable manner and, in at least one embodiment, the tissue thickness compensator 21020 can be engaged with the legs of the staples 21030 extending upwardly from the top deck surface 21012. Also similar to the above, the tissue thickness compensator 21020 can be captured within the staples 21030 when the staples 21030 are fired, i.e., pushed against the anvil 21060 by the sled 21080, and can provide various benefits such as applying a compressive force to the stapled tissue and compensating for changes in tissue thickness along the length of the staples rows, among other benefits. In such embodiments, the tissue thickness compensator 21020 can comprise a portion of the staple cartridge 20000 which is implanted. In at least one such embodiment, the tissue thickness compensator 21020 of the staple cartridge 20000 can hold the tips of the staples 21030 in position when the staples 21030 are in an unfired state.

In various embodiments, the cartridge body 21010 can comprise an inner curved portion 21013 which can be defined by a radius of curvature which, in at least one embodiment, is less than the radius of curvature 21011d which defines the fourth row of staple cavities 21011. In at least one such embodiment, the tissue thickness compensator 21020 can comprise a side which parallels, substantially parallels, matches, and/or matches the curvature of the inner curved portion 21013. When the tissue thickness compensator 21020 is positioned above and/or against the top deck surface 21012 of the cartridge body 21010, the inner curved portion of the tissue thickness compensator 21020 can be aligned, or at least substantially aligned, with the inner curved portion 21013 of the cartridge body 21010. Similarly, the cartridge body 21010 can comprise an outer curved portion 21014 which can be defined by a radius of curvature which, in at least one embodiment, is greater than the radius of curvature 21011a which defines the first row of staple cavities 21011. In at least one such embodiment, the tissue thickness compensator 21020 can comprise a side which parallels, substantially parallels, matches, and/or matches the curvature of the outer curved portion 21014. When the tissue thickness compensator 21020 is positioned above and/or against the top deck surface 21012 of the cartridge body 21010, the outer curved portion of the tissue thickness compensator 21020 can be aligned, or at least substantially aligned, with the outer curved portion 21014 of the cartridge body 21010.

As discussed above, the staple cavities 21011 can be arranged along curved rows in the cartridge body 21010. In various embodiments, the staple drivers 21090 can each be configured to be movably positioned within the staple cavities 21011 such that ramps 21081 defined on the sled 21080 can slide underneath the staple drivers 21090 and lift the staple drivers 21090, and the staples 21030 supported thereon, from an unfired position to a fired position. In some embodiments, the staple drivers 21090 can each be configured to support one staple 21030 thereon. In at least one such embodiment, the staple drivers 21090 can be loaded into the staple cavities 21011 and can be oriented at different angles with respect to each other. In certain other embodiments, the staple drivers 21090 can each be configured to support more than one staple 21030 thereon. In at least one such embodiment, the staple drivers 21090 can be curved to match the radius of curvature, or radiuses of curvature, which define the staple rows in which the staples 20030 supported thereon are positioned. In various embodiments, the ramps 21081 of the sled 21080 may be linear while, in some embodiments, the ramps 21081 may be curved. In at least one such embodiment, the ramps 21081 can be curved such that they parallel, substantially parallel, match, and/or substantially match one or more radiuses of curvature which define the staple rows. In various embodiments, the lateral portions of the sled 21080 can be curved such that they are parallel to, substantially parallel to, match, and/or substantially match curved sidewalls defined within the cartridge body 21010. In at least one such embodiment, further to the above, the sled 21080 can traverse a longitudinal cavity defined within the cartridge body 21010 as the sled 21080 is advanced from the proximal end of the staple cartridge 21000 to the distal end of the staple cartridge 21000 wherein the inner and outer sidewalls of this longitudinal cavity can be curved to match the curvature of the cartridge body 21010. In such embodiments, the lateral sides of the sled 21080 can be curved to parallel, substantially parallel, match, and/or substantially match the curvature of these sidewalls. In any event, the curved sled 21080, ramps 21081, and/or staple drivers 21090 can be curved to facilitate the ejection of the staples 21030 from the staple cavities 21011 and reduce the possibility of binding and/or jamming within the staple cartridge 21000 and/or the surgical stapling instrument.

In various embodiments, referring now to FIG. 244, a surgical stapling instrument can comprise a shaft 20050 and an end effector including a support jaw 20040 and a movable anvil jaw 20060. The surgical stapling instrument can further comprise a firing system configured to advance and/or retract a firing member 20052 relative to the end effector. Exemplary firing systems are disclosed above and, in addition, other exemplary firing systems are disclosed in contemporaneously-filed, commonly-owned U.S. patent application Ser. No. 13/241,637, entitled SURGICAL INSTRUMENT WITH TRIGGER ASSEMBLY FOR GENERATING MULTIPLE ACTUATION MOTIONS, now U.S. Pat. No. 8,789,741, the entire disclosure of which is incorporated by reference herein. As illustrated in FIGS. 244 and 245, the support jaw 20040 can be configured to receive and support a staple cartridge, such as staple cartridge 20000, for example, which can include a cartridge deck 20010, a plurality of staples 20030 removable retained within the deck 20010, and a tissue thickness compensator 20020. As described in greater detail further below, the firing member 20052 can be advanced distally toward the distal ends of jaws 20040 and 20060 in order to, one, move the anvil jaw 20060 into a closed position to compress tissue against the tissue thickness compensator 20020, two, deform the staples 20030, and/or, three, incise the tissue.

In various embodiments, referring again to FIGS. 244 and 245, the anvil 20060 can comprise a proximal end 20065, a distal end 20066, and a longitudinal slot 20064 extending therebetween. Similarly, the support jaw 20040 can further comprise a longitudinal slot 20045 extending therethrough. As described in greater detail below, the slots 20064 and 20045 can be configured to receive at least a portion of the firing member 20052 therein as the firing member 20052 is advanced distally and/or retracted proximally. In at least one such embodiment, the slots can comprise closed distal ends, such as distal end 20068, for example, which can limit the travel of the firing member 20052. In various embodiments, referring again to FIG. 244, the shaft 20050 can comprise an articulation joint 20057 which can permit the end effector of the surgical instrument, including jaws 20040 and 20060, to articulate relative to a portion of the shaft 20050. Similar to the above, the shaft 20050 can comprise an outer housing 20051 and control arms 20059 slidably housed therein wherein each control arm 20059 can include an attachment member 20058 engaged with the support jaw 20040 of the end effector, for example, and can be configured to push and/or pull the end effector to rotate it in certain directions. Referring primarily to FIG. 246, the cartridge deck 20010, in various embodiments, can be comprised of any suitable material, such as those materials described throughout this application, for example, and can have any suitable geometry. In the illustrated embodiment, the cartridge deck 20010 comprises a substantially rectangular body having longitudinal channels 20016 extending therethrough.

As outlined above, the staple cartridge 20000 can include a deck 20010 and a plurality of staples 20030 at least partially contained within the deck 20010. Referring primarily to FIGS. 245 and 246, the deck 20010 can include a plurality of apertures or through holes 20013 which can each be configured to receive at least a portion of a staple 20030 therein. In at least one embodiment, each staple 20030 can comprise a base 20031 and two legs 20032 extending from the base 20031 in a substantially U-shaped or V-shaped configuration, for example. In various embodiments, each deck aperture 20013 can comprise guide slots or grooves 20015 at the proximal and distal ends thereof which can be configured to slidably receive the legs 20032 of a staple 20030 therein. As illustrated in FIG. 246, the deck 20010 can further include a top surface 20012 and a plurality of projections, or guides, 20014 extending upwardly from the top surface 20012. In at least one embodiment, the guides 20014 can extend around or surround the proximal and/or distal ends of each aperture 20013. In various embodiments, the guide slots 20015 can extend upwardly through the guides 20014. In certain embodiments, each guide slot 20015 can be defined along an axis which is vertical. In at least one such embodiment, each guide slot 20015 can be defined along an axis which is perpendicular to a plane defined by the top surface 20012 of the deck 20010. In certain other embodiments, the guide slots 20015 can be defined along axes which are not vertical. In at least one such embodiment, each guide slot 20015 can be defined along an axis which is transverse or skew to a plane defined by the top surface 20012 of the deck 20010. In either event, the legs 20032 of the staples 20030 can be resiliently biased into the guide slots 20015. In such embodiments, the distance between the legs 20032 in their unflexed condition can be wider than the distance between the guide slots 20015 such that the legs 20032 are resiliently flexed inwardly when the staples 20030 are positioned in the apertures 20013. In at least one such embodiment, a tip distance can be defined between the tips of the staple legs 20032 which is wider than the width of the apertures 20013 and/or wider than the width between the guide slots 20015. In order to assemble such a staple cartridge, in various embodiments, the legs 20032 can be biased inwardly when the staples 20030 are positioned within the apertures 20013 and, as a result of friction forces created between the staple legs 20032 and the cartridge deck 20010, the staples 20030 can be held in position.

In various embodiments, further to the above, the guide slots 20015 can be configured to prevent, or at least limit, relative movement between the staples 20030 and the cartridge deck 20010. In at least one embodiment, the sidewalls of the guide slots can be configured such that the legs 20032 of the staples 20030 are closely received therebetween and, as a result, lateral movement between the staple legs 20032 and the cartridge deck 20010 can be prevented, or at least limited. Similarly, further to the above, relative longitudinal movement between the staple legs 20032 and the cartridge deck 20010 can be prevented, or at least limited, as the legs 20032 can be resiliently biased against proximal and distal end walls of the guide slots 20015. In various embodiments, as a result, relative movement between the staples 20030 and the cartridge deck 20010 can be limited to movement along a deployment axis toward the anvil positioned opposite the staple cartridge 20000.

Referring again to FIG. 246, the staples 20030 can be assembled into the apertures 20013 of the deck 20010 such that the staples 20030 are removably retained in an unfired position relative to the deck 20010. When the staple cartridge 20000 is installed, inserted, and/or assembled into the support jaw 20040, referring to FIG. 244, the bases 20031 of the staples 20030 can be aligned with stationary staple drivers 20043 extending upwardly from a bottom surface 20042 of the support jaw 20040, as illustrated in FIGS. 245 and 251, for example. In various embodiments, the stationary staple drivers 20043 may be immovable relative to the support jaw 20040 and can be fixed in position. In certain embodiments, the stationary staple drivers 20043 can be integrally formed with the support jaw 20040 and, in at least one embodiment, the support jaw 20040 and the stationary staple drivers 20043 can be machined from a unitary piece of material, such as stainless steel or titanium, for example. In certain embodiments, the stationary drivers 20043 can be affixed or joined to the support jaw 20040 in any suitable manner, such as by welding and/or an adhesive, for example. In any event, the bases 20031 can be positioned over the top surfaces of the stationary drivers 20043 such that the stationary drivers 20043 can support the staples 20030 as the staples 20030 are being deformed, as described in greater detail further below. In various embodiments, referring primarily to FIG. 245, each stationary driver 20043 can include a support groove or slot 20044 defined therein which can be configured to at least partially receive a base 20031 of a staple 20030 therein. In at least one embodiment, the depth of the support grooves 20044 can be greater than the diameter of the staple bases 20031 positioned therein. In at least one such embodiment, the base 20031 can be completely positioned within the support groove 20044. In certain other embodiments, the depth of the support grooves 20044 can be less than the diameter of the staple bases 20031 positioned therein. In at least one such embodiment, the top of each staple base 20031 can extend above the top surface of its corresponding stationary driver 20043. In any event, each support groove 20044 can comprise a contour configured to match, or at least substantially match, the contour of the staple base 20031 positioned therein. In at least one such embodiment, the support grooves 20044 can be at least partially defined by a radius of curvature which equals, or at least substantially equals, the radius of curvature which defines the bottom of the staple bases 20031. In certain other embodiments, the support grooves 20044 can be at least partially defined by a radius of curvature which is greater than the radius of curvature that defines the bottom of the staple bases 20031, for example. While the staples 20030 may be formed from wire having a round, or at least substantially round, outer circumference, in various embodiments, other circumferences, such as square, oval, and/or rectangular circumferences, for example, are envisioned. In such embodiments, the support grooves defined in the stationary drivers 20043 can comprise square, oval, and/or rectangular profiles, respectively, configured to receive the bases of the staples.

In various embodiments, further to the above, the stationary drivers 20043 and the support grooves 20044 defined therein can be arranged such that they are parallel to a longitudinal slot 20018 extending through the cartridge deck 20010. In such embodiments, the staples 20030 can be arranged in linear, or at least substantially linear, rows, or rows in which the staples 20030 are arranged in an end-to-end manner. In various other embodiments, the stationary drivers 20043 and/or the support grooves 20044 can be arranged along axes which extend transversely to the longitudinal slot 20018. In such embodiments, the staples 20030 can be arranged in rows which are not in an end-to-end arrangement.

As illustrated in FIG. 251, which illustrates the staple cartridge 20000 in an unfired condition, the bases 20031 of the staples 20030 can be supported by the bottom surfaces of the support grooves 20044 defined within the stationary drivers 20043. In such circumstances, the weight of the staple cartridge 20000 can be supported by the stationary drivers 20043. As also illustrated in FIG. 251, the stationary drivers 20043 can extend upwardly into the apertures 20013 of the deck 20010 when the staple cartridge 20000 is in an unfired condition. In this unfired condition, the deck 20010 is positioned above a well, cavity, or depression 20046 which is defined between the stationary staple drivers 20043. In various embodiments, a lateral gap can exist between the sidewalls of the apertures 20013 and the outer perimeter of the stationary drivers 20043. In such embodiments, a certain amount of relative lateral movement between the deck 20010 and the stationary drivers 20043 is afforded by these lateral gaps. In certain other embodiments, the sidewalls of the apertures 20013 can be in contact with the perimeter of the stationary drivers 20043. In such embodiments, an interference fit can be present between the stationary drivers 20043 and the sidewalls of the apertures 20013. In various embodiments, as described in greater detail below, the deck 20010 can slide relative to the stationary drivers 20043 as the staple cartridge 20000 is being fired. In the embodiments where there is an interference fit between the drivers 20043 and the sidewalls of the apertures 20013, the deck 20010 can slide down the stationary drivers 20043 against friction forces acting between the deck 20010 and the stationary drivers 20043. In certain embodiments, the stationary drivers 20043 can comprise an untapered profile such that each stationary driver 20043 has a constant, or at least substantially constant, outer profile, or circumference, along the height thereof. In at least one such embodiment, the friction forces present between the deck 20010 and the stationary drivers 20043 can be constant, or at least substantially constant, as the deck 20010 is moved downwardly. In certain other embodiments, the stationary drivers can comprise a tapered profile such that each stationary driver 20043 has an outer profile, or circumference, which changes along the height thereof. In at least one such embodiment, the bases of the stationary drivers 20043, or the portions of the stationary drivers 20043 closest to the bottom surface 20042 of the support jaw 20040, can be wider than the tops of the stationary drivers 20043. In such embodiments, the friction forces present between the deck 20010 and the stationary drivers 20043 can increase as the deck 20010 is pushed downwardly toward the bottom surface 20042. In any event, an interference fit between the deck 20010 and the stationary drivers 20043, and/or any other portion of support jaw 20040, can hold or retain the staple cartridge 20000 in position until it is fired, as described in greater detail further below.

Referring again to FIG. 246, the legs 20032 of the staples 20030 can extend above the deck surface 20012 and/or the staple guides 20014 when the staple cartridge 20000 is in an unfired configuration. Referring to FIG. 251, the staple cartridge 20000 can further comprise a tissue thickness compensator 20020 which can be positioned adjacent to and/or against the top deck surface 20012 of the deck 20010. In various embodiments, the legs 20032 of the staples 20030 can extend upwardly into the tissue thickness compensator 20020. In at least one such embodiment, the tissue thickness compensator 20020 can be assembled to the staple cartridge 20000 by positioning the bottom surface 20022 of the tissue thickness compensator 20020 over the top deck surface 20012 of the deck 20010 and then inserting the staples 20030 through the openings 20013 from the bottom side 20017 of the deck 20010. In at least one such embodiment, an adhesive can be utilized to hold the tissue thickness compensator 20020 to the cartridge deck 20010. In certain other embodiments, the staples 20030 can be inserted into the openings 20013 and then the tissue thickness compensator 20020 can be pressed downwardly onto the staples 20030. In either event, the tips of the staple legs 20032 can be configured to penetrate the tissue thickness compensator 20020 and, in at least one embodiment, the staple legs 20032 can each comprise a sharp, beveled tip, for example, which can pierce the tissue thickness compensator 20020. The reader will note that, when comparing FIGS. 246 and 251, the staple cartridge 20000 is illustrated with a tissue thickness compensator 20020 in FIG. 251 and without a tissue thickness compensator 20020 in FIG. 246. While the removal of the tissue thickness compensator 20020 in FIG. 246 has been done for the purposes of illustrating various aspects of the staple cartridge 20000, various embodiments are envisioned in which a staple cartridge could be utilized without a tissue thickness compensator. In at least one such embodiment, the tips of the staple legs 20032 may not extend above the staple guides 20014 of the deck 20010.

In various embodiments, referring to FIG. 246, the support jaw 20040 can include a distal end 20048 which can be configured to provide a guide for positioning the staple cartridge 20000 within the support jaw 20040. In at least one embodiment, the distal end of the cartridge deck 20010 can be aligned with the distal end 20048 and, in such a position, the bases 20031 of the staples 20030 can be aligned with the support grooves 20044. In certain embodiments, the distal end 20048 can limit the distal movement of the staple cartridge 20000. In any event, once the staple cartridge 20000 has been inserted into the support jaw 20040, referring now to FIG. 247, tissue, such as vessel V, for example, can be positioned intermediate the anvil jaw 20060 and the staple cartridge 20000. As illustrated in FIGS. 247 and 248, the anvil jaw 20060 is movable between an open position (FIG. 247) and a partially-closed position (FIG. 248) wherein, as described in greater detail further below, the surgical stapling instrument can include a firing member 20052 which can be advanced distally to engage the anvil jaw 20060 and rotate the anvil jaw 20060 toward the staple cartridge 20000 and the support jaw 20040. In at least one such embodiment, the firing member 20052 can comprise a top cam driver 20054 and a bottom cam driver 20055 which can be configured to engage the anvil jaw 20060 and the support jaw 20040, respectively. More particularly, the firing member 20052 can be advanced from an unfired position (FIG. 247) in which the cam drivers 20054 and 20055 are not engaged with the jaws 20040 and 20060 to a partially-advanced position (FIG. 248) in which the top cam driver 20054 is in contact with a cam surface 20062 on the anvil jaw 20060 and the bottom cam driver 20055 is in contact with a cam surface 20039 on the support jaw 20040. As the firing member 20052 is progressed distally, the anvil jaw 20060 can be moved toward the support jaw 20040 thereby bringing a tissue-contacting surface 20061 into contact with the vessel V, and/or any other suitable tissue positioned between the jaws 20040 and 20060. In at least one such embodiment, the top cam driver 20054 can slide relative to the cam surface 20062 and cam the anvil jaw 20060 toward the staple cartridge 20000 until the top cam driver 20054 reaches the top, or outer, surface 20038 of the anvil jaw 20060. Similarly, the bottom cam driver 20055 can slide relative to the cam surface 20039 until the bottom cam driver 20055 reaches the bottom, or outside, surface 20037 of the support jaw 20040. In certain embodiments, the bottom cam driver 20055 can reach the bottom surface 20037 of the support jaw 20040 before the top cam driver 20054 reaches the top surface 20038 of the anvil jaw 20060. In certain embodiments, the bottom cam driver 20055 can reach the bottom surface 20037 of the support jaw 20040 after the top cam driver 20054 reaches the top surface 20038 of the anvil jaw 20060. In certain other embodiments, the bottom cam driver 20055 can reach the bottom surface 20037 at the same time that the top cam driver 20054 reaches the top surface 20038. In any event, once the cam drivers 20054 and 20055 have reached their respective surfaces 20038 and 20037, the anvil jaw 20060 can be in a fully closed position.

In various embodiments, further to the above, a surgeon can utilize the surgical stapling instrument to grasp, manipulate, and/or otherwise evaluate the tissue positioned between the jaws 20040 and 20060. In at least one such embodiment, the surgeon may only partially advance the firing member 20052 such that the anvil 20060 is only moved to a partially-closed position, as illustrated in FIG. 248. In the event that the surgeon wishes to re-evaluate the positioning of the end effector, the surgeon may retract the firing member 20052 thereby allowing the anvil 20060 to return to an open position. In various embodiments, the surgical instrument can further include a spring configured to bias the anvil 20060 into an open position such that the anvil jaw 20060 can return to an open position after the firing member 20052 has been retracted. In such embodiments, the surgeon can partially close and re-open the anvil 20060 as many times as appropriate in order to properly position the tissue between the anvil jaw 20060 and the staple cartridge 20000. FIGS. 253 and 254 depict an end view of the anvil jaw 20060 being moved between an open position and an at least partially-closed position. When the anvil jaw 20060 is in the partially-closed position illustrated in FIG. 248, the reader will note that the vessel V has distorted from the compression force applied thereto; however, the reader will also note that the tissue thickness compensator 20020 has not distorted, or at least substantially distorted, from the same compression force. The reader will also note that the tissue T in FIG. 253 can be distorted when it is compressed by an at least partially closed anvil jaw 20060, as illustrated in FIG. 254, although the tissue thickness compensator 20020 may remain undistorted. In some such embodiments, the tissue thickness compensator 20020 can comprise a modulus of elasticity that is greater than the modulus of elasticity of the tissue T and/or the vessel V positioned between the tissue thickness compensator 20020 and the tissue contacting surface 20061 of the anvil jaw 20060. Such embodiments can allow the tissue and/or vessel to be compressed and/or manipulated without pushing the tissue or vessel against the tips of the staples 20030 embedded within the tissue thickness compensator 20020. As the anvil 20060 is pushed closer toward the support jaw 20040, as illustrated in FIG. 249, the tissue thickness compensator 20020 can compress downwardly toward the deck 20010. In such circumstances, depending on the height of the staple legs 20032, the tips of the staple legs 20032 may or may not at least partially pierce the tissue or vessel. In either event, referring now to FIG. 250, the firing member 20052 can be further advanced toward the distal end of the end effector to fire the staple cartridge 20000, as described in greater detail below.

As discussed above, the cartridge deck 20010 can be slid downwardly toward the bottom surface 20042 of the support jaw 20040 as the staple cartridge 20000 is being fired. Referring to FIGS. 248 and 249, the reader will note that the cartridge deck 20010 is moved from an unfired position (FIG. 248) to a fired position (FIG. 249) as the firing member 20052 is advanced distally. The movement of the cartridge deck 20010 between an unfired position and a fired position is also illustrated in FIGS. 251 and 252 and, in addition, in FIGS. 254 and 255. Upon comparing FIGS. 251 and 252, the cartridge deck 20010 can be pushed downwardly into the well 20046 as the staples 20030 are being deformed. More specifically, as the anvil jaw 20060 is pushed downwardly toward the support jaw 20040, the tissue contacting surface 20061 can contact tissue positioned intermediate the tissue contacting surface 20061 and the top surface 20021 of the tissue thickness compensator 20020 and push the tissue downwardly toward the support jaw 20040. This compressive force can also push the top surface 20021 of the tissue thickness compensator 20020 downwardly toward the support jaw 20040 thereby compressing the tissue thickness compensator 20020. As the tissue thickness compensator 20020 is compressed, the top surface 20021 can be pushed below the tips of the staple legs 2002 such that the staple legs 20032 emerge from the tissue thickness compensator 20032 and pierce the tissue. Further downward movement of the anvil 20060 can position one or more forming surfaces on the anvil jaw 20060 against the staple legs 20032. In various embodiments, the anvil jaw 20060 can comprise a plurality of forming pockets 20063 which can be configured to receive the staple legs 20032 of the staples 20030 and bend or curl the staple legs 20032 downwardly, for example. Ultimately, the anvil jaw 20060 can be pushed downwardly until the staples 20030 have been sufficiently deformed, or fired.

In various embodiments, further to the above, the anvil jaw 20060 can be moved toward the support jaw 20040 until the staples 20030 have been deformed, or fired, to a desired height. In various embodiments, the firing member 20052 can be advanced distally to push the anvil 20060 downwardly until the desired deformed height of the staples 20030 has been reached. In at least one circumstance, the firing member 20052 can push the anvil jaw 20060 to its final height when the upper cam driver 20054 has reached the top surface 20038 of the anvil jaw 20060 and the bottom cam driver 20055 has reached the bottom surface 20039 of the support jaw 20040. In such circumstances, the movement of the anvil jaw 20060 to its fully-closed position is sufficient to fully form the staples 20030 to their desired deformed height. In at least one such circumstance, all of the staples 20030 can be deformed to their desired height simultaneously. In various circumstances, the anvil 20060 can be rotated between its open position and its closed position wherein the rotation of the anvil jaw 20060 can be centered about an axis defined by closure pins 20069 extending from the anvil jaw 20060. Referring primarily to FIG. 245, the closure pins 20069 can extend from the lateral sides of the anvil jaw 20060 and can be positioned along an axis of rotation. In various embodiments, the support jaw 20040 can include pin slots 20049 defined in opposite sides thereof which are each configured to receive a pin 20069 therein. As described in greater detail below, the pins 20069 can rotate and/or translate within the pin slots 20049. When the anvil jaw 20060 is moved from an open position to a partially-closed position as illustrated in FIGS. 247 and 248, in at least one embodiment, the anvil jaw 20060 can be rotated about the pins 20069 after being contacted by the advancing firing member 20052. Along these lines, the reader will note that the closure pins 20069 have remained in the top portions of the pin slots 20049 which indicates that, in the current circumstances, the anvil jaw 20060 has not yet been translated downwardly. Various other circumstances are envisioned in which the anvil jaw 20060 is translated in addition to or in lieu of being rotated as it is moved from its open position to a partially-closed position. Upon comparing FIGS. 248 and 249, the reader will note that the firing member 20052 has been advanced distally and that the anvil jaw 20060 has been moved further toward the support jaw 20040. While the anvil jaw 20060 has been rotated between its position in FIG. 248 and its position in FIG. 249, the anvil 20060 has also translated toward the support jaw 20040, as evidenced by the downward movement of the pins 20069 in the pin slots 20049.

As outlined above, the pins 20069 of the anvil jaw 20060 may slide downwardly within the pin slots 20049 of the support jaw 20040 when the anvil jaw 20060 is moved between its position in FIG. 248 and its position in FIG. 249. In various embodiments, each pin slot 20049 can be defined along a longitudinal axis 20068 and can be configured to limit the movement of the pins 20069 along a straight line, or an at least substantially straight line. In at least one embodiment, the longitudinal axes 20068 can be perpendicular, or at least substantially perpendicular, to the bottom surface 20042 of the support jaw 20040. In such embodiments, the anvil jaw 20060 can move in a parallel, or an at least substantial parallel, path toward the bottom surface 20042 of the support jaw 20040. More particularly, in at least one embodiment, the tissue-contacting surface 20061 can comprise a flat, or planar, surface which can be moved downwardly toward the support jaw 20040 such that the tissue-contacting surface 20061 remains parallel, or at least substantially parallel, to a planar surface defining the bottom surface 20042. In various embodiments, the tissue-contacting surface 20061 can be moved downwardly toward the top surface 20021 of the tissue thickness compensator 20020 such that the tissue-contacting surface 20061 remains parallel, or at least substantially parallel, to the top surface 20021. In certain embodiments, the tissue-contacting surface 20061 can be moved downwardly toward the deck surface 20012 of the cartridge deck 20010 such that the tissue-contacting surface 20061 remains parallel, or at least substantially parallel, to the deck surface 20012. In at least one embodiment, the deck 20010 can be pushed downwardly such that the bottom surface 20017 of the deck 20010 remains parallel, or at least substantially parallel, to the bottom surface 20042 of the support jaw 20040. In various embodiments, further to the above, the longitudinal axes 20068 can extend transversely with respect to the bottom surface 20042 of the support jaw 20040, the deck surface 20012 of the cartridge deck 20010, and/or the top surface 20021 of the tissue thickness compensator 20020, for example. In certain embodiments, the top surface 20038 of the anvil jaw 20060 can be parallel to the tissue contacting surface 20061 of the anvil jaw 20060 and, similarly, the outer surface 20038 of the support jaw 20040 can be parallel to the bottom surface 20042 of the support jaw 20040.

In various embodiments, further to the above, the anvil jaw 20060 can float downwardly as it is closed. The anvil jaw 20060 can translate and/or rotate downwardly such that the tissue-contacting surface 20061 of the anvil jaw 20060 moves downwardly in a level, or at least substantially level, manner. When the anvil jaw 20060 is level as it is closed, in certain embodiments, the forming pockets 20063 of the anvil jaw 20060 can deform all, or at least nearly all, of the staples 20030 at the same time. Furthermore, in at least some embodiments, the forming pockets 20063 can deform all, or at least nearly all, of the staples 20030 to the same, or at least substantially the same, height, as the anvil is floated downwardly. The anvil 20060 can also float as the firing member 20052 is advanced distally and/or retracted proximally. In various embodiments, the anvil 20060 can tilt proximally and/or distally and/or otherwise adjust as the staple cartridge 20000, for example, is being fired.

In various embodiments, further to the above, the longitudinal axes 20068 can be perpendicular, or at least substantially perpendicular, to a plane defined by the top surfaces of the stationary staple drivers 20043. In such embodiments, the anvil jaw 20060 can move in a parallel, or an at least substantial parallel, path toward this plane. More particularly, in at least one embodiment, the tissue-contacting surface 20061 can comprise or define a flat, or planar, surface which can be moved downwardly toward the support jaw 20040 such that the tissue-contacting surface 20061 remains parallel, or at least substantially parallel, to the top surfaces of the stationary staple drivers 20043. In certain embodiments, however, not all of the top surfaces of the stationary staple drivers 20043 may lie in the same plane. In some embodiments, the stationary staple drivers 20043 may have different heights and, thus, the top surfaces of the staple drivers 20043 may lie within different planes. In at least one embodiment, the stationary staple drivers 20043 within a first row may have a first height and the stationary staple drivers 20043 within a second row may have a second height. In at least one such embodiment, the tips of the staples 20030 supported by such stationary staple drivers 20043 can be supported at different heights with respect to the bottom surface 20042 of the support jaw 20040 in their unfired position. In such circumstances, especially in embodiments in which all of the staples 20030 have the same or at least substantially the same unfired height, the staples 20030 supported by taller stationary staple drivers 20043 can be deformed a greater amount than the staples 20030 supported by the shorter stationary staple drivers 20043. In certain embodiments, the staples 20030 can have different unfired heights. In at least one such embodiment, staples 20030 having a shorter unfired height can be positioned on the taller stationary staple drivers 20043 while the staples 20030 having a taller unfired height can be positioned on the shorter stationary staple drivers 20043, for example. In certain other embodiments, staples 20030 having a shorter unfired height can be positioned on the shorter stationary staple drivers 20043 while the staples 20030 having a taller unfired height can be positioned on the taller stationary staple drivers 20043. In various embodiments, the support jaw 20040 can include several rows of stationary staple drivers 20043 having a first height and several rows of stationary staple drivers 20043 having a second height. In certain embodiments, the support jaw 20040 can include a first row of stationary staple drivers 20043 having a first height, a second row of stationary staple drivers 20043 having a second height, and one or more additional rows of stationary staple drivers 20043 having a height which is different than the first height and the second height. In various embodiments, as described above, the height of a stationary staple driver 20043 can be measured between the bottom surface 20042 and the top surface of the stationary staple driver 20043; alternatively, the height of a stationary staple driver 20043 can be measured from the bottom surface 20042 to the bottom of the staple support groove 20044 defined therein. U.S. patent application Ser. No. 11/711,979, filed Feb. 28, 2007, entitled SURGICAL STAPLING DEVICES THAT PRODUCE FORMED STAPLES HAVING DIFFERENT LENGTHS, now U.S. Pat. No. 8,317,070, is hereby incorporated by reference in its entirety.

As discussed above, the firing member 20052 can be advanced distally in order to position the anvil 20060 in a fully closed position. In some circumstances, as also discussed above, the firing member 20052 can fully close the anvil 20060 when the top camming member 20054 of the firing member 20052 first engages the top surface 20038 of the anvil jaw 20060 and the bottom camming member 20055 first engages the bottom surface 20039 of the support jaw 20040. In various circumstances, however, the initial distal movement of the firing member 20052 may not be sufficient to move the anvil 20060 to its fully closed position and fully form the staples 20030. In such circumstances, the firing member 20052 may progressively move the anvil 20060 into its fully fired position as the firing member 20052 is moved distally. In various embodiments, the firing member 20052 can first form the proximal-most staples 20030 to their fully-fired position and then progressively form each staple 20030 to its fully deformed height as the firing member 20052 passes the staples 20030. In such embodiments, a fixed distance, or height, can be defined between the top camming member 20054 and the bottom camming member 20055 such that anvil jaw 20060 and the support jaw 20040 are closer together than the fixed height defined between the camming members 20054 and 20055. Thus, the height of the anvil jaw 20060 can be controlled, or at least controlled in the region of the end effector proximate the camming members 20054 and 20055. As the firing member 20052 is advanced distally, the staples 20030 of the staple cartridge 20000 can be formed to their final deformed heights until the firing member 20052 reaches the distal end of the end effector. At such point, the firing member 20052 can be retracted to its proximal, unfired position and the anvil jaw 20060 can be reopened. In some circumstances, the firing member 20052 can be retracted prior to being advanced to the distal end of the end effector.

As the cartridge deck 20010 is moved downwardly into the well 20046 from its unfired position to its fired position, referring now to FIGS. 254 and 255, the cartridge deck 20010 can become lodged within the well 20046. More particularly, as outlined above, the cartridge deck 20010 can engage the support jaw 20040 in an interference-fit or press-fit manner as the cartridge deck 20010 is pushed downwardly such that the cartridge deck 20010 can be held in its fired position. In certain circumstances, the staples 20030 may not be engaged with the deck 20010 when the deck 20010 is in its fired position and, thus, when the anvil jaw 20060 is reopened after the staple cartridge 20000 has been fired, the staples 20030, the tissue T captured within the staples 20030, and/or the tissue thickness compensator 20020 can be lifted away from the support jaw 20040 and the cartridge deck 20010. In at least some such embodiments, the cartridge deck 20010 can remain affixed to the support jaw 20040 until the cartridge deck 20010 is removed from the support jaw 20040. In various embodiments, as discussed above, the sidewalls of the apertures 20013 defined within the deck 20010 can be configured to engage the stationary staple drivers 20043 as the cartridge deck 20010 descends into the well 20046. In certain embodiments, the support jaw 20040 and the cartridge deck 20010 can include other co-operating features which can create an interference fit therebetween. Such co-operating features could include apertures defined in the support jaw 20040 and downwardly-depending cones extending from the cartridge deck 20010, for example, which cold be configured to enter into the apertures defined in the support jaw 20040 and engage the sidewalls thereof. In various embodiments, the cartridge deck 20010 can comprise a unitary piece of material which moves downwardly as the staple cartridge 20000 is being fired. In certain other embodiments, the cartridge deck 20010 can comprise several portions which can move relative to one another. In at least one such embodiment, the portions of the cartridge deck 20010 can be held together by one or more frangible connectors which can be configured to break as the staple cartridge 20000 is being compressed by the anvil jaw 20060. In at least one embodiment, the connectors can be configured to hold the portions of the cartridge deck 20010 together when the anvil jaw 20060 is closed but break as the firing member 20052 passes thereby. In such embodiments, the connected portions of the cartridge deck 20010 can be progressively released from the cartridge deck 20010 as the firing member 20052 is moved distally. Thus, the proximal-most portions of the cartridge deck 20010 can be pushed downwardly to their fully-fired positions before the middle portions and the distal portions of cartridge deck 20010 are pushed downwardly to their fully-fired positions. As the firing member 20052 is advanced, the middle portions of the cartridge deck 20010 can be pushed downwardly to their fully-fired positions followed by the distal-most portions of the cartridge deck 20010, for example.

In various embodiments, further to the above, the firing member 20052 can further comprise a cutting portion 20053, such as a knife edge, for example, which can be configured to incise the tissue as the firing member is progressed from its unfired position to a fired position. The cutting portion 20053 can be positioned and arranged such that it lags the cam drivers 20054 and 20055 and passes through the longitudinal slot 20018. In such embodiments, the cam drivers 20054 and 20055 can progressively deform the staples 20030 to the desired height, or at least assure that staples 20030 have been deformed to the desired height, as the cutting portion 20053 follows behind the drivers 20054 and 20055 and progressively cuts the tissue. In certain embodiments, referring again to FIG. 246, the cartridge deck 20010 can comprise a plurality of portions, such as first and second sides, for example, which can be held together by one or more cuttable ties holding the plurality of portions together. In at least one such embodiment, the cartridge deck 20010 can comprise ties 20019 positioned within the slot 20018 which can be severed and/or broken by the cutting portion 20053 as the cutting portion 20053 is moved from its unfired position to its fired position. Thus, in various embodiments, the first and second portions of the cartridge deck 20010 can be progressively released from one another as the firing member 20052 is advanced. In certain embodiments, the ties 20019 may be sufficiently frangible such that they can break as the cartridge deck 20010 is pushed downwardly by the anvil jaw 20060 to deform the staples 20030, for example. In at least one such embodiment, one or more of the ties 20019 may already be broken prior to the advancement of the firing member 20052.

As described above, the staple cartridge 20000 can be supported on the support jaw 20040 in any suitable manner. In various embodiments, referring now to FIG. 245, the support jaw 20040 can further comprise supports 20047 which can be configured to support the cartridge deck 20010. In at least one such embodiment, the supports 20047 can extend vertically along the sides of the stationary staple drivers 20043 and can each comprise a top surface against which the cartridge deck 20010 can be positioned. Referring now to FIG. 246, the cartridge deck 20010 can include ledges 20006 which can abut the supports 20047. In at least one such embodiment, each ledge 20006 can at least partially define the end of a channel 20007 extending through the body 20011 of the cartridge deck 20010. Referring now to FIG. 256, each ledge 20006 can be defined by a certain thickness extending between a bottom surface 20017 of the ledge 20006 to a top surface wherein the bottom surface 20017 can contact a top portion of a support 20047. In certain embodiments, the bottom surfaces 20017 of the ledges 20006 may not contact the supports 20047 in the unfired condition of the staple cartridge 20000; however, in such embodiments, the bottom surfaces 20017 can come into contact with the supports 20047 as the staple cartridge 20000 is fired and the cartridge deck 20010 is moved downwardly. When the ledges 20006 of the cartridge deck 20010 are in contact with the supports 20047, the downward movement of the cartridge deck 20010 can be prevented, or at least inhibited, until the ledges 20006 deform and/or break thereby allowing the cartridge deck 20010 to move downwardly into its fired position. Referring to FIG. 257, the ledges 20006 can be configured to break, fold, and/or otherwise deflect inwardly into the channels 20007. When the ledges 20006 have been folded into the channels 20007, sufficient clearance can exist between the cartridge deck 20010 and the stationary staple drivers 20043 to permit the cartridge deck 20010 to move relative thereto. In various embodiments, further to the above, the ledges 20006 can break, snap, and/or otherwise plastically deform, in order to permit relative movement between the cartridge deck 20010 and the support jaw 20040. In certain embodiments, the ledges 20006 may not need to break in order to permit such relative movement. In at least one such embodiment, the ledges 20006 can be configured to flex, bend, and/or otherwise elastically deform, into the channels 20007, for example, to permit relative movement between the cartridge deck 20010 and the support jaw 20040.

Further to the above, regardless of whether the ledges 20060, and/or any other suitable support members, of the cartridge deck 20010 plastically deform and/or elastically deform, the co-operation of the ledges 20006 and the supports 20047 can prevent, or at least inhibit, the downward movement of the cartridge deck 20010 until a certain force or pressure has been applied to the staple cartridge 20000 by the anvil jaw 20060 and/or the firing member 20052. In various embodiments, the ledges 20006 can be configured to break-away, i.e., suddenly permit relative movement between the cartridge deck 20010 and the support jaw 20040, when a predetermined force transmitted through the ledges 20006 has been reached or exceeded. In at least one embodiment, each ledge 20006 of a cartridge deck 20010 can be configured to break-away at the same predetermined force. Other embodiments are envisioned in which the ledges 20006 of a cartridge deck 20010 can be configured to break-away at different predetermined forces. In either event, such break-away features can delineate when the staple cartridge 20000 has transitioned between an unfired configuration and an at least partially-fired configuration. Referring to FIGS. 256 and 257 once again, the cartridge deck 20010 has moved toward, or broken-away toward, the bases 20032 of the staples 20030 and the bottom surface 20042 of the support jaw 20040. In certain embodiments, the cartridge deck 20010 can break-away at the same time that the anvil jaw 20060 starts to deform the staples 20030. In certain other embodiments, the cartridge deck 20010 can break-away at the same time that the staples 20030 are being deformed to their final deformed configurations. In various embodiments, the cartridge deck 20010 can be configured to collapse when a sufficient compressive force, or pressure, is applied thereto. In at least one embodiment, the cartridge deck 20010 can comprise a plurality of downwardly-depending supports which can be configured to abut the bottom surface 20042 of the support jaw 20040 wherein such supports can be configured to collapse when a sufficient compressive force, or pressure, is applied to, or transmitted through, the cartridge deck 20010.

Referring to FIGS. 256 and 257 once again, the cartridge deck 20010 can collapse toward the bases 20032 of the staples 20030 and the bottom surface 20042 of the support jaw 20040. In at least one such embodiment, the top surface 20042 of the cartridge deck 20010 can move closer to the bases 20031 of the staples 20030 as the cartridge deck 20010 is moved between an unfired position (FIG. 256) and a fired position (FIG. 257). In various embodiments, the top surface 20012 of the cartridge deck 20010 can be positioned above the top surfaces of the stationary staple drivers 20043 when the cartridge deck 20010 is in an unfired configuration, as illustrated in FIG. 256, and positioned below the top surfaces of the stationary staple drivers 20043 when the cartridge deck 20010 is in a fired configuration, as illustrated in FIG. 257. In the fired configuration of the cartridge deck 20010, as a result, the stationary staple drivers 20043 can protrude upwardly from the cartridge deck 20010. In at least one such embodiment, the top surface 20012 of the cartridge deck 20010 can be positioned above the bases 20031 of the staples 20030 when the cartridge deck 20010 is in its unfired configuration and, in certain embodiments, the top surface 20012 can be aligned, or at least substantially aligned, with the bases 20031 of the staples 20030 when the cartridge deck 20010 is in its fired configuration. In various embodiments, the bottom surface 20017 of the cartridge deck 20010 can be aligned, or at least substantially aligned, with the bases 20031 of the staples 20030 when the cartridge deck 20010 is in its unfired configuration and, in certain embodiments, the bottom surface 20017 can be positioned below the bases 20031 when the cartridge deck 20010 is in its fired configuration. In the unfired configuration of the cartridge deck 20010, referring again to FIG. 257, the bottom surface 20017 can be positioned above the bottom surface 20042 of the support jaw 20040, as illustrated in FIG. 256, and can contact the bottom surface 20042 when the cartridge deck 20010 is moved into its fired configuration, as illustrated in FIG. 257. In any event, when the cartridge deck 20010 is moved downwardly toward the bottom surface 20042 of the support jaw 20040, the cartridge deck 20010 can be moved in the direction of the bases 20031 of the staples 20030, for example.

As discussed above, the stationary staple drivers 20043 can be configured to support the staples 20030 along straight, or at least substantially straight, rows, or lines. In such embodiments, the stationary staple drivers 20043 can also be positioned along straight, or at least substantially straight, rows. In at least one such embodiment, the support grooves 20044 defined in the stationary staple drivers 20043 can each be defined along a longitudinal axis which is collinear, or at least substantially collinear, with the longitudinal axes defined by at least some of the other support grooves 20044. In certain embodiments, the stationary staple drivers 20043 can be configured to support the staples 20030 along at least partially curved rows. In such embodiments, the stationary staple drivers 20043 can also be positioned along curved rows. In at least one such embodiment, the support grooves 20044 defined in the stationary staple drivers 20043 can each be defined along a longitudinal axis which is not collinear with the other longitudinal axes defined by the support grooves 20044 along the curved portion of the staple row.

In various embodiments, as outlined above, the staple cartridge 20000 can be positioned on a first side of the targeted tissue and the anvil jaw 20060 can be positioned on a second, or opposite, side of the tissue. In certain circumstances, the distal ends of the support jaw 20040 and the anvil jaw 20060 can be aligned with the targeted tissue and then pushed distally such that the tissue is located between the proximal and distal ends of the staple cartridge 20000. As also outlined above, the tissue thickness compensator 20020 of the staple cartridge 20000 can comprise various tissue-contacting surfaces, such as surface 20021, for example. In certain embodiments, the tissue thickness compensator 20020 may include any suitable number of bevels, radiused edges, and/or other suitable surfaces, such as lead-in surface 20028, for example, which can facilitate the insertion of the tissue proximal to the tissue thickness compensator 20020 without dislodging the tissue thickness compensator 20020 from the staple cartridge 20000.

The devices disclosed herein can be designed to be disposed of after a single use, or they can be designed to be used multiple times. In either case, however, the device can be reconditioned for reuse after at least one use. Reconditioning can include any combination of the steps of disassembly of the device, followed by cleaning or replacement of particular pieces, and subsequent reassembly. In particular, the device can be disassembled, and any number of the particular pieces or parts of the device can be selectively replaced or removed in any combination. Upon cleaning and/or replacement of particular parts, the device can be reassembled for subsequent use either at a reconditioning facility, or by a surgical team immediately prior to a surgical procedure. Those skilled in the art will appreciate that reconditioning of a device can utilize a variety of techniques for disassembly, cleaning/replacement, and reassembly. Use of such techniques, and the resulting reconditioned device, are all within the scope of the present application.

Preferably, the invention described herein will be processed before surgery. First, a new or used instrument is obtained and if necessary cleaned. The instrument can then be sterilized. In one sterilization technique, the instrument is placed in a closed and sealed container, such as a plastic or TYVEK bag. The container and instrument are then placed in a field of radiation that can penetrate the container, such as gamma radiation, x-rays, or high-energy electrons. The radiation kills bacteria on the instrument and in the container. The sterilized instrument can then be stored in the sterile container. The sealed container keeps the instrument sterile until it is opened in the medical facility.

Any patent, publication, or other disclosure material, in whole or in part, that is said to be incorporated by reference herein is incorporated herein only to the extent that the incorporated materials does not conflict with existing definitions, statements, or other disclosure material set forth in this disclosure. As such, and to the extent necessary, the disclosure as explicitly set forth herein supersedes any conflicting material incorporated herein by reference. Any material, or portion thereof, that is said to be incorporated by reference herein, but which conflicts with existing definitions, statements, or other disclosure material set forth herein will only be incorporated to the extent that no conflict arises between that incorporated material and the existing disclosure material.

While this invention has been described as having exemplary designs, the present invention may be further modified within the spirit and scope of the disclosure. This application is therefore intended to cover any variations, uses, or adaptations of the invention using its general principles. Further, this application is intended to cover such departures from the present disclosure as come within known or customary practice in the art to which this invention pertains.

Claims

1. An end effector for stapling patient tissue, said end effector comprising:

a frame comprising a proximal end and a distal end;
a plurality of staples;
a firing system configured to implant said staples into the patient tissue;
an implantable layer comprising a tissue-contacting surface and a support surface; and
an array of securement members extending above and below said support surface of said implantable layer, wherein said securement members are detached from said frame concurrently with said firing system being actuated to implant said staples.

2. The end effector of claim 1, further comprising a cutting member movable from said proximal end toward said distal end to transect the patient tissue.

3. The end effector of claim 1, wherein said firing system comprises:

staple supports which support said staples when said firing system is actuated; and
an anvil configured to deform said staples, wherein a first distance is defined between said staple supports and said anvil prior to said firing system being actuated, and wherein a second distance is defined between said staple supports and said anvil after said firing system has been actuated which is different than said first distance.

4. The end effector of claim 1, wherein said staples comprise:

a first longitudinal row of first staples having a first unfired height; and
a second longitudinal row of second staples having a second unfired height which is different than said first unfired height.

5. An end effector for stapling patient tissue, said end effector comprising:

a frame comprising a proximal end and a distal end;
a plurality of staples;
a firing system configured to implant said staples into the patient tissue;
an implantable layer comprising a tissue-contacting surface and a bottom surface; and
a plurality of retainers extending above and below said bottom surface of said implantable layer, wherein said retainers are released from said frame when said firing system is actuated to implant said staples.

6. The end effector of claim 5, further comprising a cutting member movable from said proximal end toward said distal end to transect the patient tissue.

7. The end effector of claim 5, wherein said firing system comprises:

staple supports which support said staples when said firing system is actuated; and
an anvil configured to deform said staples, wherein a first distance is defined between said staple supports and said anvil prior to said firing system being actuated, and wherein a second distance is defined between said staple supports and said anvil after said firing system has been actuated which is different than said first distance.

8. The end effector of claim 5, wherein said staples comprise:

a first longitudinal row of first staples having a first unfired height; and
a second longitudinal row of second staples having a second unfired height which is different than said first unfired height.

9. An end effector for stapling patient tissue, said end effector comprising:

a frame comprising a proximal end and a distal end;
a plurality of staples;
a firing system configured to implant said staples into the patient tissue;
an implantable layer comprising a tissue-contacting surface and a bottom surface; and
a plurality of securement members extending above and below said bottom surface of said implantable layer, wherein said securement members are mechanically disrupted when said firing system is actuated to implant said staples.

10. The end effector of claim 9, further comprising a cutting member movable from said proximal end toward said distal end to transect the patient tissue.

11. The end effector of claim 9, wherein said firing system comprises:

staple supports which support said staples when said firing system is actuated; and
an anvil configured to deform said staples, wherein a first distance is defined between said staple supports and said anvil prior to said firing system being actuated, and wherein a second distance is defined between said staple supports and said anvil after said firing system has been actuated which is different than said first distance.

12. The end effector of claim 9, wherein said staples comprise:

a first longitudinal row of first staples having a first unfired height; and
a second longitudinal row of second staples having a second unfired height which is different than said first unfired height.

13. An end effector for stapling patient tissue, said end effector comprising:

a staple cartridge comprising a proximal end and a distal end;
a plurality of staples, comprising: a first longitudinal row of first staples having a first unfired height; and a second longitudinal row of second staples having a second unfired height which is different than said first unfired height;
a firing system configured to implant said staples into the patient tissue;
an implantable layer comprising a cartridge-facing surface; and
a plurality of retainers extending above and below said cartridge-facing surface of said implantable layer which are mechanically disrupted when said firing system is actuated to implant said staples.

14. The end effector of claim 13, further comprising a cutting member movable from said proximal end toward said distal end to transect the patient tissue.

15. The end effector of claim 13, wherein said firing system comprises:

staple supports which support said staples when said firing system is actuated; and
an anvil configured to deform said staples, wherein a first distance is defined between said staple supports and said anvil prior to said firing system being actuated, and wherein a second distance is defined between said staple supports and said anvil after said firing system has been actuated which is different than said first distance.
Referenced Cited
U.S. Patent Documents
66052 June 1867 Smith
662587 November 1900 Blake
670748 March 1901 Weddeler
951393 March 1910 Hahn
1306107 June 1919 Elliott
1314601 September 1919 McCaskey
1677337 July 1928 Grove
1794907 March 1931 Kelly
2037727 April 1936 La Chapelle
2132295 October 1938 Hawkins
2161632 June 1939 Nattenheimer
2211117 August 1940 Hess
2214870 September 1940 West
2318379 May 1943 Davis et al.
2329440 September 1943 La Place
2441096 May 1948 Happe
2448741 September 1948 Scott et al.
2450527 October 1948 Smith et al.
2526902 October 1950 Rublee
2527256 October 1950 Jackson
2578686 December 1951 Fish
2674149 April 1954 Benson
2711461 June 1955 Happe
2804848 September 1957 O'Farrell et al.
2808482 October 1957 Zanichkowsky et al.
2853074 September 1958 Olson
2887004 May 1959 Stewart
2959974 November 1960 Emrick
3032769 May 1962 Palmer
3075062 January 1963 Iaccarino
3078465 February 1963 Bobrov
3079606 March 1963 Bobrov et al.
3166072 January 1965 Sullivan, Jr.
3196869 July 1965 Scholl
3204731 September 1965 Bent et al.
3266494 August 1966 Brownrigg et al.
3269630 August 1966 Fleischer
3275211 September 1966 Hirsch et al.
3317103 May 1967 Cullen et al.
3317105 May 1967 Astafjev et al.
3357296 December 1967 Lefever
3490675 January 1970 Green et al.
3494533 February 1970 Green et al.
3499591 March 1970 Green
3503396 March 1970 Pierie et al.
3551987 January 1971 Wilkinson
3568675 March 1971 Harvey
3572159 March 1971 Tschanz
3583393 June 1971 Takahashi
3598943 August 1971 Barrett
3608549 September 1971 Merrill
3640317 February 1972 Panfili
3643851 February 1972 Green et al.
3661666 May 1972 Foster et al.
3662939 May 1972 Bryan
3695646 October 1972 Mommsen
3709221 January 1973 Riely
3717294 February 1973 Green
3734207 May 1973 Fishbein
3740994 June 1973 DeCarlo, Jr.
3744495 July 1973 Johnson
3746002 July 1973 Haller
3751902 August 1973 Kingsbury et al.
3799151 March 1974 Fukaumi et al.
3819100 June 1974 Noiles et al.
3821919 July 1974 Knohl
3841474 October 1974 Maier
3851196 November 1974 Hinds
3885491 May 1975 Curtis
3892228 July 1975 Mitsui
3894174 July 1975 Cartun
3940844 March 2, 1976 Colby et al.
3950686 April 13, 1976 Randall
3955581 May 11, 1976 Spasiano et al.
RE28932 August 17, 1976 Noiles et al.
3981051 September 21, 1976 Brumlik
4054108 October 18, 1977 Gill
4060089 November 29, 1977 Noiles
4106446 August 15, 1978 Yamada et al.
4111206 September 5, 1978 Vishnevsky et al.
4129059 December 12, 1978 Van Eck
4169990 October 2, 1979 Lerdman
4180285 December 25, 1979 Reneau
4198734 April 22, 1980 Brumlik
4198982 April 22, 1980 Fortner et al.
4207898 June 17, 1980 Becht
4213562 July 22, 1980 Garrett et al.
4226242 October 7, 1980 Jarvik
4244372 January 13, 1981 Kapitanov et al.
4250436 February 10, 1981 Weissman
4261244 April 14, 1981 Becht et al.
4272002 June 9, 1981 Moshofsky
4272662 June 9, 1981 Simpson
4274304 June 23, 1981 Curtiss
4275813 June 30, 1981 Noiles
4289133 September 15, 1981 Rothfuss
4296654 October 27, 1981 Mercer
4304236 December 8, 1981 Conta et al.
4305539 December 15, 1981 Korolkov et al.
4312685 January 26, 1982 Riedl
4317451 March 2, 1982 Cerwin et al.
4321002 March 23, 1982 Froehlich
4328839 May 11, 1982 Lyons et al.
4331277 May 25, 1982 Green
4340331 July 20, 1982 Savino
4347450 August 31, 1982 Colligan
4349028 September 14, 1982 Green
4353371 October 12, 1982 Cosman
4373147 February 8, 1983 Carlson, Jr.
4379457 April 12, 1983 Gravener et al.
4380312 April 19, 1983 Landrus
4382326 May 10, 1983 Rabuse
4383634 May 17, 1983 Green
4393728 July 19, 1983 Larson et al.
4396139 August 2, 1983 Hall et al.
4397311 August 9, 1983 Kanshin et al.
4402445 September 6, 1983 Green
4408692 October 11, 1983 Siegel et al.
4409057 October 11, 1983 Molenda et al.
4415112 November 15, 1983 Green
4416276 November 22, 1983 Newton et al.
4428376 January 31, 1984 Mericle
4429695 February 7, 1984 Green
4434796 March 6, 1984 Karapetian et al.
4438659 March 27, 1984 Desplats
4442964 April 17, 1984 Becht
4448194 May 15, 1984 DiGiovanni et al.
4451743 May 29, 1984 Suzuki et al.
4454887 June 19, 1984 Krüger
4467805 August 28, 1984 Fukuda
4470414 September 11, 1984 Imagawa et al.
4473077 September 25, 1984 Noiles et al.
4475679 October 9, 1984 Fleury, Jr.
4485816 December 4, 1984 Krumme
4485817 December 4, 1984 Swiggett
4486928 December 11, 1984 Tucker et al.
4488523 December 18, 1984 Shichman
4489875 December 25, 1984 Crawford et al.
4499895 February 19, 1985 Takayama
4500024 February 19, 1985 DiGiovanni et al.
4505272 March 19, 1985 Utyamyshev et al.
4505273 March 19, 1985 Braun et al.
4505414 March 19, 1985 Filipi
4506671 March 26, 1985 Green
4512038 April 23, 1985 Alexander et al.
4520817 June 4, 1985 Green
4522327 June 11, 1985 Korthoff et al.
4526174 July 2, 1985 Froehlich
4527724 July 9, 1985 Chow et al.
4530453 July 23, 1985 Green
4531522 July 30, 1985 Bedi et al.
4532927 August 6, 1985 Miksza, Jr.
4548202 October 22, 1985 Duncan
4565109 January 21, 1986 Tsay
4565189 January 21, 1986 Mabuchi
4566620 January 28, 1986 Green et al.
4569469 February 11, 1986 Mongeon et al.
4571213 February 18, 1986 Ishimoto
4573468 March 4, 1986 Conta et al.
4573469 March 4, 1986 Golden et al.
4573622 March 4, 1986 Green et al.
4576167 March 18, 1986 Noiles et al.
4580712 April 8, 1986 Green
4585153 April 29, 1986 Failla et al.
4589416 May 20, 1986 Green
4591085 May 27, 1986 Di Giovanni
4597753 July 1, 1986 Turley
4600037 July 15, 1986 Hatten
4604786 August 12, 1986 Howie, Jr.
4605001 August 12, 1986 Rothfuss et al.
4605004 August 12, 1986 Di Giovanni et al.
4606343 August 19, 1986 Conta et al.
4607638 August 26, 1986 Crainich
4608981 September 2, 1986 Rothfuss et al.
4610250 September 9, 1986 Green
4610383 September 9, 1986 Rothfuss et al.
4619262 October 28, 1986 Taylor
4619391 October 28, 1986 Sharkany et al.
4628459 December 9, 1986 Shinohara et al.
4629107 December 16, 1986 Fedotov et al.
4632290 December 30, 1986 Green et al.
4633874 January 6, 1987 Chow et al.
4634419 January 6, 1987 Kreizman et al.
4641076 February 3, 1987 Linden
4643731 February 17, 1987 Eckenhoff
4646722 March 3, 1987 Silverstein et al.
4655222 April 7, 1987 Florez et al.
4662555 May 5, 1987 Thornton
4663874 May 12, 1987 Sano et al.
4664305 May 12, 1987 Blake, III et al.
4665916 May 19, 1987 Green
4667674 May 26, 1987 Korthoff et al.
4669647 June 2, 1987 Storace
4671445 June 9, 1987 Barker et al.
4676245 June 30, 1987 Fukuda
4684051 August 4, 1987 Akopov et al.
4691703 September 8, 1987 Auth et al.
4693248 September 15, 1987 Failla
4700703 October 20, 1987 Resnick et al.
4708141 November 24, 1987 Inoue et al.
4709120 November 24, 1987 Pearson
4715520 December 29, 1987 Roehr, Jr. et al.
4719917 January 19, 1988 Barrows et al.
4727308 February 23, 1988 Huljak et al.
4728020 March 1, 1988 Green et al.
4728876 March 1, 1988 Mongeon et al.
4729260 March 8, 1988 Dudden
4730726 March 15, 1988 Holzwarth
4741336 May 3, 1988 Failla et al.
4743214 May 10, 1988 Tai-Cheng
4747820 May 31, 1988 Hornlein et al.
4750902 June 14, 1988 Wuchinich et al.
4752024 June 21, 1988 Green et al.
4754909 July 5, 1988 Barker et al.
4767044 August 30, 1988 Green
4773420 September 27, 1988 Green
4777780 October 18, 1988 Holzwarth
4787387 November 29, 1988 Burbank, III et al.
4790225 December 13, 1988 Moody et al.
4805617 February 21, 1989 Bedi et al.
4805823 February 21, 1989 Rothfuss
4809695 March 7, 1989 Gwathmey et al.
4815460 March 28, 1989 Porat et al.
4817847 April 4, 1989 Redtenbacher et al.
4819853 April 11, 1989 Green
4821939 April 18, 1989 Green
4827911 May 9, 1989 Broadwin et al.
4830855 May 16, 1989 Stewart
4834720 May 30, 1989 Blinkhorn
4844068 July 4, 1989 Arata et al.
4848637 July 18, 1989 Pruitt
4856078 August 8, 1989 Konopka
4865030 September 12, 1989 Polyak
4868530 September 19, 1989 Ahs
4869414 September 26, 1989 Green et al.
4869415 September 26, 1989 Fox
4873977 October 17, 1989 Avant et al.
4875486 October 24, 1989 Rapoport et al.
4880015 November 14, 1989 Nierman
4890613 January 2, 1990 Golden et al.
4892244 January 9, 1990 Fox et al.
4893622 January 16, 1990 Green et al.
4896678 January 30, 1990 Ogawa
4900303 February 13, 1990 Lemelson
4903697 February 27, 1990 Resnick et al.
4915100 April 10, 1990 Green
4930503 June 5, 1990 Pruitt
4930674 June 5, 1990 Barak
4931047 June 5, 1990 Broadwin et al.
4932960 June 12, 1990 Green et al.
4933843 June 12, 1990 Scheller et al.
4938408 July 3, 1990 Bedi et al.
4941623 July 17, 1990 Pruitt
4943182 July 24, 1990 Hoblingre
4944443 July 31, 1990 Oddsen et al.
4951860 August 28, 1990 Peters et al.
4955959 September 11, 1990 Tompkins et al.
4965709 October 23, 1990 Ngo
4973274 November 27, 1990 Hirukawa
4978049 December 18, 1990 Green
4978333 December 18, 1990 Broadwin et al.
4986808 January 22, 1991 Broadwin et al.
4988334 January 29, 1991 Hornlein et al.
4996975 March 5, 1991 Nakamura
5002543 March 26, 1991 Bradshaw et al.
5002553 March 26, 1991 Shiber
5005754 April 9, 1991 Van Overloop
5009661 April 23, 1991 Michelson
5014899 May 14, 1991 Presty et al.
5015227 May 14, 1991 Broadwin et al.
5018515 May 28, 1991 Gilman
5018657 May 28, 1991 Pedlick et al.
5024671 June 18, 1991 Tu et al.
5027834 July 2, 1991 Pruitt
5031814 July 16, 1991 Tompkins et al.
5035040 July 30, 1991 Kerrigan et al.
5038109 August 6, 1991 Goble et al.
5040715 August 20, 1991 Green et al.
5042707 August 27, 1991 Taheri
5061269 October 29, 1991 Muller
5062563 November 5, 1991 Green et al.
5065929 November 19, 1991 Schulze et al.
5071052 December 10, 1991 Rodak et al.
5071430 December 10, 1991 de Salis et al.
5074454 December 24, 1991 Peters
5079006 January 7, 1992 Urquhart
5080556 January 14, 1992 Carreno
5083695 January 28, 1992 Foslien et al.
5084057 January 28, 1992 Green et al.
5088979 February 18, 1992 Filipi et al.
5088997 February 18, 1992 Delahuerga et al.
5094247 March 10, 1992 Hernandez et al.
5100420 March 31, 1992 Green et al.
5104025 April 14, 1992 Main et al.
5104397 April 14, 1992 Vasconcelos et al.
5106008 April 21, 1992 Tompkins et al.
5108368 April 28, 1992 Hammerslag et al.
5111987 May 12, 1992 Moeinzadeh et al.
5116349 May 26, 1992 Aranyi
5122156 June 16, 1992 Granger et al.
5124990 June 23, 1992 Williamson
5129570 July 14, 1992 Schulze et al.
5137198 August 11, 1992 Nobis et al.
5139513 August 18, 1992 Segato
5141144 August 25, 1992 Foslien et al.
5142932 September 1, 1992 Moya et al.
5155941 October 20, 1992 Takahashi et al.
5156315 October 20, 1992 Green et al.
5156609 October 20, 1992 Nakao et al.
5156614 October 20, 1992 Green et al.
5158567 October 27, 1992 Green
D330699 November 3, 1992 Gill
5163598 November 17, 1992 Peters et al.
5171247 December 15, 1992 Hughett et al.
5171249 December 15, 1992 Stefanchik et al.
5171253 December 15, 1992 Klieman et al.
5188111 February 23, 1993 Yates et al.
5190517 March 2, 1993 Zieve et al.
5190544 March 2, 1993 Chapman et al.
5190560 March 2, 1993 Woods et al.
5192288 March 9, 1993 Thompson et al.
5195968 March 23, 1993 Lundquist et al.
5197648 March 30, 1993 Gingold
5197649 March 30, 1993 Bessler et al.
5197966 March 30, 1993 Sommerkamp
5200280 April 6, 1993 Karasa
5205459 April 27, 1993 Brinkerhoff et al.
5207697 May 4, 1993 Carusillo et al.
5209747 May 11, 1993 Knoepfler
5211649 May 18, 1993 Kohler et al.
5211655 May 18, 1993 Hasson
5217457 June 8, 1993 Delahuerga et al.
5217478 June 8, 1993 Rexroth
5219111 June 15, 1993 Bilotti et al.
5221036 June 22, 1993 Takase
5221281 June 22, 1993 Klicek
5222963 June 29, 1993 Brinkerhoff et al.
5222975 June 29, 1993 Crainich
5222976 June 29, 1993 Yoon
5223675 June 29, 1993 Taft
5234447 August 10, 1993 Kaster et al.
5236440 August 17, 1993 Hlavacek
5239981 August 31, 1993 Anapliotis
5240163 August 31, 1993 Stein et al.
5242457 September 7, 1993 Akopov et al.
5244462 September 14, 1993 Delahuerga et al.
5246156 September 21, 1993 Rothfuss et al.
5246443 September 21, 1993 Mai
5253793 October 19, 1993 Green et al.
5258009 November 2, 1993 Conners
5258012 November 2, 1993 Luscombe et al.
5259366 November 9, 1993 Reydel et al.
5259835 November 9, 1993 Clark et al.
5260637 November 9, 1993 Pizzi
5263629 November 23, 1993 Trumbull et al.
5263973 November 23, 1993 Cook
5264218 November 23, 1993 Rogozinski
5268622 December 7, 1993 Philipp
5271543 December 21, 1993 Grant et al.
5271544 December 21, 1993 Fox et al.
RE34519 January 25, 1994 Fox et al.
5275323 January 4, 1994 Schulze et al.
5275608 January 4, 1994 Forman et al.
5279416 January 18, 1994 Malec et al.
5281216 January 25, 1994 Klicek
5282806 February 1, 1994 Haber et al.
5282829 February 1, 1994 Hermes
5284128 February 8, 1994 Hart
5285381 February 8, 1994 Iskarous et al.
5285945 February 15, 1994 Brinkerhoff et al.
5289963 March 1, 1994 McGarry et al.
5290271 March 1, 1994 Jernberg
5292053 March 8, 1994 Bilotti et al.
5297714 March 29, 1994 Kramer
5304204 April 19, 1994 Bregen
5307976 May 3, 1994 Olson et al.
5309387 May 3, 1994 Mori et al.
5309927 May 10, 1994 Welch
5312023 May 17, 1994 Green et al.
5312024 May 17, 1994 Grant et al.
5312329 May 17, 1994 Beaty et al.
5314424 May 24, 1994 Nicholas
5314445 May 24, 1994 Heidmueller et al.
5314466 May 24, 1994 Stern et al.
5318221 June 7, 1994 Green et al.
5330487 July 19, 1994 Thornton et al.
5330502 July 19, 1994 Hassler et al.
5332142 July 26, 1994 Robinson et al.
5333422 August 2, 1994 Warren et al.
5333772 August 2, 1994 Rothfuss et al.
5333773 August 2, 1994 Main et al.
5334183 August 2, 1994 Wuchinich
5336232 August 9, 1994 Green et al.
5339799 August 23, 1994 Kami et al.
5341724 August 30, 1994 Vatel
5341810 August 30, 1994 Dardel
5342381 August 30, 1994 Tidemand
5342395 August 30, 1994 Jarrett et al.
5342396 August 30, 1994 Cook
5343391 August 30, 1994 Mushabac
5344060 September 6, 1994 Gravener et al.
5344454 September 6, 1994 Clarke et al.
5346504 September 13, 1994 Ortiz et al.
5348259 September 20, 1994 Blanco et al.
5350388 September 27, 1994 Epstein
5350391 September 27, 1994 Iacovelli
5350400 September 27, 1994 Esposito et al.
5352229 October 4, 1994 Goble et al.
5352235 October 4, 1994 Koros et al.
5352238 October 4, 1994 Green et al.
5354303 October 11, 1994 Spaeth et al.
5356006 October 18, 1994 Alpern et al.
5358506 October 25, 1994 Green et al.
5358510 October 25, 1994 Luscombe et al.
5359231 October 25, 1994 Flowers et al.
D352780 November 22, 1994 Glaeser et al.
5360305 November 1, 1994 Kerrigan
5360428 November 1, 1994 Hutchinson, Jr.
5364001 November 15, 1994 Bryan
5364003 November 15, 1994 Williamson, IV
5366133 November 22, 1994 Geiste
5366134 November 22, 1994 Green et al.
5366479 November 22, 1994 McGarry et al.
5368015 November 29, 1994 Wilk
5368592 November 29, 1994 Stern et al.
5370645 December 6, 1994 Klicek et al.
5372124 December 13, 1994 Takayama et al.
5372596 December 13, 1994 Klicek et al.
5372602 December 13, 1994 Burke
5374277 December 20, 1994 Hassler
5376095 December 27, 1994 Ortiz
5379933 January 10, 1995 Green et al.
5381649 January 17, 1995 Webb
5381782 January 17, 1995 DeLaRama et al.
5382247 January 17, 1995 Cimino et al.
5383880 January 24, 1995 Hooven
5383881 January 24, 1995 Green et al.
5383888 January 24, 1995 Zvenyatsky et al.
5383895 January 24, 1995 Holmes et al.
5389098 February 14, 1995 Tsuruta et al.
5389104 February 14, 1995 Hahnen et al.
5391180 February 21, 1995 Tovey et al.
5392979 February 28, 1995 Green et al.
5395030 March 7, 1995 Kuramoto et al.
5395033 March 7, 1995 Byrne et al.
5395034 March 7, 1995 Allen et al.
5395312 March 7, 1995 Desai
5395384 March 7, 1995 Duthoit
5397046 March 14, 1995 Savage et al.
5397324 March 14, 1995 Carroll et al.
5403312 April 4, 1995 Yates et al.
5405072 April 11, 1995 Zlock et al.
5405073 April 11, 1995 Porter
5405344 April 11, 1995 Williamson et al.
5405360 April 11, 1995 Tovey
5407293 April 18, 1995 Crainich
5408409 April 18, 1995 Glassman
5409498 April 25, 1995 Braddock et al.
5411481 May 2, 1995 Allen et al.
5411508 May 2, 1995 Bessler et al.
5413107 May 9, 1995 Oakley et al.
5413267 May 9, 1995 Solyntjes et al.
5413268 May 9, 1995 Green et al.
5413272 May 9, 1995 Green et al.
5413573 May 9, 1995 Koivukangas
5415334 May 16, 1995 Williamson, IV et al.
5415335 May 16, 1995 Knodell, Jr.
5417203 May 23, 1995 Tovey et al.
5417361 May 23, 1995 Williamson, IV
5421829 June 6, 1995 Olichney et al.
5422567 June 6, 1995 Matsunaga
5423471 June 13, 1995 Mastri et al.
5423809 June 13, 1995 Klicek
5425745 June 20, 1995 Green et al.
5431322 July 11, 1995 Green et al.
5431654 July 11, 1995 Nic
5431668 July 11, 1995 Burbank, III et al.
5433721 July 18, 1995 Hooven et al.
5437681 August 1, 1995 Meade et al.
5438302 August 1, 1995 Goble
5439155 August 8, 1995 Viola
5439156 August 8, 1995 Grant et al.
5439479 August 8, 1995 Schichman et al.
5441191 August 15, 1995 Linden
5441193 August 15, 1995 Gravener
5441483 August 15, 1995 Avitall
5441494 August 15, 1995 Ortiz
5444113 August 22, 1995 Sinclair et al.
5445155 August 29, 1995 Sieben
5445304 August 29, 1995 Plyley et al.
5445644 August 29, 1995 Pietrafitta et al.
5447265 September 5, 1995 Vidal et al.
5447417 September 5, 1995 Kuhl et al.
5447513 September 5, 1995 Davison et al.
5449355 September 12, 1995 Rhum et al.
5449365 September 12, 1995 Green et al.
5449370 September 12, 1995 Vaitekunas
5452836 September 26, 1995 Huitema et al.
5452837 September 26, 1995 Williamson, IV et al.
5454378 October 3, 1995 Palmer et al.
5454827 October 3, 1995 Aust et al.
5456401 October 10, 1995 Green et al.
5458579 October 17, 1995 Chodorow et al.
5462215 October 31, 1995 Viola et al.
5464013 November 7, 1995 Lemelson
5464144 November 7, 1995 Guy et al.
5464300 November 7, 1995 Crainich
5465894 November 14, 1995 Clark et al.
5465895 November 14, 1995 Knodel et al.
5465896 November 14, 1995 Allen et al.
5466020 November 14, 1995 Page et al.
5467911 November 21, 1995 Tsuruta et al.
5468253 November 21, 1995 Bezwada et al.
5470006 November 28, 1995 Rodak
5470007 November 28, 1995 Plyley et al.
5470009 November 28, 1995 Rodak
5470010 November 28, 1995 Rothfuss et al.
5472132 December 5, 1995 Savage et al.
5472442 December 5, 1995 Klicek
5473204 December 5, 1995 Temple
5474057 December 12, 1995 Makower et al.
5474223 December 12, 1995 Viola et al.
5474566 December 12, 1995 Alesi et al.
5476206 December 19, 1995 Green et al.
5476479 December 19, 1995 Green et al.
5478003 December 26, 1995 Green et al.
5478354 December 26, 1995 Tovey et al.
5480089 January 2, 1996 Blewett
5480409 January 2, 1996 Riza
5482197 January 9, 1996 Green et al.
5484095 January 16, 1996 Green et al.
5484398 January 16, 1996 Stoddard
5484451 January 16, 1996 Akopov et al.
5485947 January 23, 1996 Olson et al.
5485952 January 23, 1996 Fontayne
5487499 January 30, 1996 Sorrentino et al.
5487500 January 30, 1996 Knodel et al.
5489058 February 6, 1996 Plyley et al.
5489256 February 6, 1996 Adair
5496312 March 5, 1996 Klicek
5496317 March 5, 1996 Goble et al.
5497933 March 12, 1996 DeFonzo et al.
5501654 March 26, 1996 Failla et al.
5503320 April 2, 1996 Webster et al.
5503635 April 2, 1996 Sauer et al.
5503638 April 2, 1996 Cooper et al.
5505363 April 9, 1996 Green et al.
5507426 April 16, 1996 Young et al.
5509596 April 23, 1996 Green et al.
5509916 April 23, 1996 Taylor
5511564 April 30, 1996 Wilk
5514129 May 7, 1996 Smith
5514157 May 7, 1996 Nicholas et al.
5518163 May 21, 1996 Hooven
5518164 May 21, 1996 Hooven
5520678 May 28, 1996 Heckele et al.
5520700 May 28, 1996 Beyar et al.
5522817 June 4, 1996 Sander et al.
5522831 June 4, 1996 Sleister et al.
5527320 June 18, 1996 Carruthers et al.
5529235 June 25, 1996 Boiarski et al.
D372086 July 23, 1996 Grasso et al.
5531305 July 2, 1996 Roberts et al.
5531744 July 2, 1996 Nardella et al.
5533521 July 9, 1996 Granger
5533581 July 9, 1996 Barth et al.
5533661 July 9, 1996 Main et al.
5535934 July 16, 1996 Boiarski et al.
5535935 July 16, 1996 Vidal et al.
5535937 July 16, 1996 Boiarski et al.
5540375 July 30, 1996 Bolanos et al.
5541376 July 30, 1996 Ladtkow et al.
5542594 August 6, 1996 McKean et al.
5542949 August 6, 1996 Yoon
5543119 August 6, 1996 Sutter et al.
5547117 August 20, 1996 Hamblin et al.
5549583 August 27, 1996 Sanford et al.
5549621 August 27, 1996 Bessler et al.
5549627 August 27, 1996 Kieturakis
5549628 August 27, 1996 Cooper et al.
5549637 August 27, 1996 Crainich
5551622 September 3, 1996 Yoon
5553675 September 10, 1996 Pitzen et al.
5553765 September 10, 1996 Knodel et al.
5554148 September 10, 1996 Aebischer et al.
5554169 September 10, 1996 Green et al.
5556416 September 17, 1996 Clark et al.
5558665 September 24, 1996 Kieturakis
5558671 September 24, 1996 Yates
5560530 October 1, 1996 Bolanos et al.
5560532 October 1, 1996 DeFonzo et al.
5561881 October 8, 1996 Klinger et al.
5562239 October 8, 1996 Boiarski et al.
5562241 October 8, 1996 Knodel et al.
5562682 October 8, 1996 Oberlin et al.
5562690 October 8, 1996 Green et al.
5562701 October 8, 1996 Huitema et al.
5562702 October 8, 1996 Huitema et al.
5563481 October 8, 1996 Krause
5564615 October 15, 1996 Bishop et al.
5569161 October 29, 1996 Ebling et al.
5569270 October 29, 1996 Weng
5569284 October 29, 1996 Young et al.
5571090 November 5, 1996 Sherts
5571100 November 5, 1996 Goble et al.
5571116 November 5, 1996 Bolanos et al.
5571285 November 5, 1996 Chow et al.
5571488 November 5, 1996 Beerstecher et al.
5573543 November 12, 1996 Akopov et al.
5574431 November 12, 1996 McKeown et al.
5575054 November 19, 1996 Klinzing et al.
5575789 November 19, 1996 Bell et al.
5575799 November 19, 1996 Bolanos et al.
5575803 November 19, 1996 Cooper et al.
5575805 November 19, 1996 Li
5577654 November 26, 1996 Bishop
5579978 December 3, 1996 Green et al.
5580067 December 3, 1996 Hamblin et al.
5582611 December 10, 1996 Tsuruta et al.
5582617 December 10, 1996 Klieman et al.
5584425 December 17, 1996 Savage et al.
5586711 December 24, 1996 Plyley et al.
5588579 December 31, 1996 Schnut et al.
5588580 December 31, 1996 Paul et al.
5588581 December 31, 1996 Conlon et al.
5591170 January 7, 1997 Spievack et al.
5591187 January 7, 1997 Dekel
5597107 January 28, 1997 Knodel et al.
5599151 February 4, 1997 Daum et al.
5599279 February 4, 1997 Slotman et al.
5599344 February 4, 1997 Paterson
5599350 February 4, 1997 Schulze et al.
5599852 February 4, 1997 Scopelianos et al.
5601224 February 11, 1997 Bishop et al.
5601573 February 11, 1997 Fogelberg et al.
5603443 February 18, 1997 Clark et al.
5605272 February 25, 1997 Witt et al.
5605273 February 25, 1997 Hamblin et al.
5607094 March 4, 1997 Clark et al.
5607095 March 4, 1997 Smith et al.
5607433 March 4, 1997 Polla et al.
5607450 March 4, 1997 Zvenyatsky et al.
5609285 March 11, 1997 Grant et al.
5609601 March 11, 1997 Kolesa et al.
5611709 March 18, 1997 McAnulty
5613966 March 25, 1997 Makower et al.
5615820 April 1, 1997 Viola
5618294 April 8, 1997 Aust et al.
5618303 April 8, 1997 Marlow et al.
5618307 April 8, 1997 Donlon et al.
5619992 April 15, 1997 Guthrie et al.
5620289 April 15, 1997 Curry
5620452 April 15, 1997 Yoon
5624398 April 29, 1997 Smith et al.
5624452 April 29, 1997 Yates
5626587 May 6, 1997 Bishop et al.
5626595 May 6, 1997 Sklar et al.
5628446 May 13, 1997 Geiste et al.
5628743 May 13, 1997 Cimino
5628745 May 13, 1997 Bek
5630539 May 20, 1997 Plyley et al.
5630540 May 20, 1997 Blewett
5630541 May 20, 1997 Williamson, IV et al.
5630782 May 20, 1997 Adair
5632432 May 27, 1997 Schulze et al.
5632433 May 27, 1997 Grant et al.
5634584 June 3, 1997 Okorocha et al.
5636779 June 10, 1997 Palmer
5636780 June 10, 1997 Green et al.
5639008 June 17, 1997 Gallagher et al.
5643291 July 1, 1997 Pier et al.
5645209 July 8, 1997 Green et al.
5647526 July 15, 1997 Green et al.
5647869 July 15, 1997 Goble et al.
5649937 July 22, 1997 Bito et al.
5649956 July 22, 1997 Jensen et al.
5651491 July 29, 1997 Heaton et al.
5653373 August 5, 1997 Green et al.
5653374 August 5, 1997 Young et al.
5653677 August 5, 1997 Okada et al.
5653721 August 5, 1997 Knodel et al.
5655698 August 12, 1997 Yoon
5657429 August 12, 1997 Wang et al.
5657921 August 19, 1997 Young et al.
5658238 August 19, 1997 Suzuki et al.
5658281 August 19, 1997 Heard
5658300 August 19, 1997 Bito et al.
5658307 August 19, 1997 Exconde
5662258 September 2, 1997 Knodel et al.
5662260 September 2, 1997 Yoon
5662662 September 2, 1997 Bishop et al.
5665085 September 9, 1997 Nardella
5667517 September 16, 1997 Hooven
5667526 September 16, 1997 Levin
5667527 September 16, 1997 Cook
5669544 September 23, 1997 Schulze et al.
5669904 September 23, 1997 Platt, Jr. et al.
5669907 September 23, 1997 Platt, Jr. et al.
5669918 September 23, 1997 Balazs et al.
5673840 October 7, 1997 Schulze et al.
5673841 October 7, 1997 Schulze et al.
5673842 October 7, 1997 Bittner et al.
5674286 October 7, 1997 D'Alessio et al.
5678748 October 21, 1997 Plyley et al.
5680981 October 28, 1997 Mililli et al.
5680982 October 28, 1997 Schulze et al.
5680983 October 28, 1997 Plyley et al.
5683349 November 4, 1997 Makower et al.
5685474 November 11, 1997 Seeber
5686090 November 11, 1997 Schilder et al.
5688270 November 18, 1997 Yates et al.
5690269 November 25, 1997 Bolanos et al.
5692668 December 2, 1997 Schulze et al.
5693020 December 2, 1997 Rauh
5693042 December 2, 1997 Boiarski et al.
5693051 December 2, 1997 Schulze et al.
5695494 December 9, 1997 Becker
5695502 December 9, 1997 Pier et al.
5695504 December 9, 1997 Gifford, III et al.
5695524 December 9, 1997 Kelley et al.
5697542 December 16, 1997 Knodel et al.
5697543 December 16, 1997 Burdorff
5697909 December 16, 1997 Eggers et al.
5697943 December 16, 1997 Sauer et al.
5700270 December 23, 1997 Peyser et al.
5702387 December 30, 1997 Arts et al.
5702408 December 30, 1997 Wales et al.
5702409 December 30, 1997 Rayburn et al.
5704087 January 6, 1998 Strub
5704534 January 6, 1998 Huitema et al.
5706997 January 13, 1998 Green et al.
5706998 January 13, 1998 Plyley et al.
5707392 January 13, 1998 Kortenbach
5709334 January 20, 1998 Sorrentino et al.
5709680 January 20, 1998 Yates et al.
5709706 January 20, 1998 Kienzle et al.
5711472 January 27, 1998 Bryan
5712460 January 27, 1998 Carr et al.
5713128 February 3, 1998 Schrenk et al.
5713505 February 3, 1998 Huitema
5713895 February 3, 1998 Lontine et al.
5713896 February 3, 1998 Nardella
5713920 February 3, 1998 Bezwada et al.
5715987 February 10, 1998 Kelley et al.
5715988 February 10, 1998 Palmer
5716366 February 10, 1998 Yates
5718359 February 17, 1998 Palmer et al.
5718360 February 17, 1998 Green et al.
5718548 February 17, 1998 Costellessa
5718714 February 17, 1998 Livneh
5720744 February 24, 1998 Eggleston et al.
D393067 March 31, 1998 Geary et al.
5725536 March 10, 1998 Oberlin et al.
5725554 March 10, 1998 Simon et al.
5728110 March 17, 1998 Vidal et al.
5728121 March 17, 1998 Bimbo et al.
5730758 March 24, 1998 Allgeyer
5732821 March 31, 1998 Stone et al.
5732871 March 31, 1998 Clark et al.
5732872 March 31, 1998 Bolduc et al.
5733308 March 31, 1998 Daugherty et al.
5735445 April 7, 1998 Vidal et al.
5735848 April 7, 1998 Yates et al.
5735874 April 7, 1998 Measamer et al.
5738474 April 14, 1998 Blewett
5738648 April 14, 1998 Lands et al.
5743456 April 28, 1998 Jones et al.
5747953 May 5, 1998 Philipp
5749889 May 12, 1998 Bacich et al.
5749893 May 12, 1998 Vidal et al.
5752644 May 19, 1998 Bolanos et al.
5752965 May 19, 1998 Francis et al.
5755717 May 26, 1998 Yates et al.
5758814 June 2, 1998 Gallagher et al.
5762255 June 9, 1998 Chrisman et al.
5762256 June 9, 1998 Mastri et al.
5766188 June 16, 1998 Igaki
5766205 June 16, 1998 Zvenyatsky et al.
5769748 June 23, 1998 Eyerly et al.
5769892 June 23, 1998 Kingwell
5772379 June 30, 1998 Evensen
5772578 June 30, 1998 Heimberger et al.
5772659 June 30, 1998 Becker et al.
5776130 July 7, 1998 Buysse et al.
5778939 July 14, 1998 Hok-Yin
5779130 July 14, 1998 Alesi et al.
5779131 July 14, 1998 Knodel et al.
5779132 July 14, 1998 Knodel et al.
5782396 July 21, 1998 Mastri et al.
5782397 July 21, 1998 Koukline
5782749 July 21, 1998 Riza
5782859 July 21, 1998 Nicholas et al.
5784934 July 28, 1998 Izumisawa
5785232 July 28, 1998 Vidal et al.
5785647 July 28, 1998 Tompkins et al.
5787897 August 4, 1998 Kieturakis
5792135 August 11, 1998 Madhani et al.
5792165 August 11, 1998 Klieman et al.
5794834 August 18, 1998 Hamblin et al.
5796188 August 18, 1998 Bays
5797536 August 25, 1998 Smith et al.
5797537 August 25, 1998 Oberlin et al.
5797538 August 25, 1998 Heaton et al.
5797906 August 25, 1998 Rhum et al.
5797959 August 25, 1998 Castro et al.
5799857 September 1, 1998 Robertson et al.
5800379 September 1, 1998 Edwards
5800423 September 1, 1998 Jensen
5806676 September 15, 1998 Wasgien
5807376 September 15, 1998 Viola et al.
5807378 September 15, 1998 Jensen et al.
5807393 September 15, 1998 Williamson, IV et al.
5809441 September 15, 1998 McKee
5810721 September 22, 1998 Mueller et al.
5810811 September 22, 1998 Yates et al.
5810846 September 22, 1998 Virnich et al.
5810855 September 22, 1998 Rayburn et al.
5813813 September 29, 1998 Daum et al.
5814055 September 29, 1998 Knodel et al.
5814057 September 29, 1998 Oi et al.
5816471 October 6, 1998 Plyley et al.
5817084 October 6, 1998 Jensen
5817091 October 6, 1998 Nardella et al.
5817093 October 6, 1998 Williamson, IV et al.
5817109 October 6, 1998 McGarry et al.
5817119 October 6, 1998 Klieman et al.
5820009 October 13, 1998 Melling et al.
5823066 October 20, 1998 Huitema et al.
5824333 October 20, 1998 Scopelianos et al.
5826776 October 27, 1998 Schulze et al.
5827271 October 27, 1998 Buysse et al.
5827298 October 27, 1998 Hart et al.
5829662 November 3, 1998 Allen et al.
5833690 November 10, 1998 Yates et al.
5833695 November 10, 1998 Yoon
5833696 November 10, 1998 Whitfield et al.
5836503 November 17, 1998 Ehrenfels et al.
5836960 November 17, 1998 Kolesa et al.
5839639 November 24, 1998 Sauer et al.
5843021 December 1, 1998 Edwards et al.
5843096 December 1, 1998 Igaki et al.
5843097 December 1, 1998 Mayenberger et al.
5843122 December 1, 1998 Riza
5843132 December 1, 1998 Ilvento
5843169 December 1, 1998 Taheri
5846254 December 8, 1998 Schulze et al.
5849011 December 15, 1998 Jones et al.
5849023 December 15, 1998 Mericle
5855311 January 5, 1999 Hamblin et al.
5855583 January 5, 1999 Wang et al.
5860581 January 19, 1999 Robertson et al.
5860975 January 19, 1999 Goble et al.
5865361 February 2, 1999 Milliman et al.
5868760 February 9, 1999 McGuckin, Jr.
5871135 February 16, 1999 Williamson, IV et al.
5873885 February 23, 1999 Weidenbenner
5876401 March 2, 1999 Schulze et al.
5878193 March 2, 1999 Wang et al.
5878607 March 9, 1999 Nunes et al.
5878937 March 9, 1999 Green et al.
5878938 March 9, 1999 Bittner et al.
5891160 April 6, 1999 Williamson, IV et al.
5893506 April 13, 1999 Powell
5893835 April 13, 1999 Witt et al.
5893878 April 13, 1999 Pierce
5894979 April 20, 1999 Powell
5897552 April 27, 1999 Edwards et al.
5897562 April 27, 1999 Bolanos et al.
5899914 May 4, 1999 Zirps et al.
5901895 May 11, 1999 Heaton et al.
5902312 May 11, 1999 Frater et al.
5903117 May 11, 1999 Gregory
5904647 May 18, 1999 Ouchi
5904693 May 18, 1999 Dicesare et al.
5904702 May 18, 1999 Ek et al.
5906625 May 25, 1999 Bito et al.
5908402 June 1, 1999 Blythe
5908427 June 1, 1999 McKean et al.
5911353 June 15, 1999 Bolanos et al.
5915616 June 29, 1999 Viola et al.
5916225 June 29, 1999 Kugel
5918791 July 6, 1999 Sorrentino et al.
5919198 July 6, 1999 Graves, Jr. et al.
5921956 July 13, 1999 Grinberg et al.
5928256 July 27, 1999 Riza
5931847 August 3, 1999 Bittner et al.
5931853 August 3, 1999 McEwen et al.
5937951 August 17, 1999 Izuchukwu et al.
5938667 August 17, 1999 Peyser et al.
5941442 August 24, 1999 Geiste et al.
5941890 August 24, 1999 Voegele et al.
5944172 August 31, 1999 Hannula
5944715 August 31, 1999 Goble et al.
5947984 September 7, 1999 Whipple
5948030 September 7, 1999 Miller et al.
5951516 September 14, 1999 Bunyan
5951552 September 14, 1999 Long et al.
5951574 September 14, 1999 Stefanchik et al.
5951581 September 14, 1999 Saadat et al.
5954259 September 21, 1999 Viola et al.
5964394 October 12, 1999 Robertson
5964774 October 12, 1999 McKean et al.
5971916 October 26, 1999 Koren
5973221 October 26, 1999 Collyer et al.
5977746 November 2, 1999 Hershberger et al.
5984949 November 16, 1999 Levin
5988479 November 23, 1999 Palmer
5997528 December 7, 1999 Bisch et al.
5997552 December 7, 1999 Person et al.
6001108 December 14, 1999 Wang et al.
6003517 December 21, 1999 Sheffield et al.
6004319 December 21, 1999 Goble et al.
6004335 December 21, 1999 Vaitekunas et al.
6010054 January 4, 2000 Johnson et al.
6010513 January 4, 2000 Tormälä et al.
6012494 January 11, 2000 Balazs
6013076 January 11, 2000 Goble et al.
6015406 January 18, 2000 Goble et al.
6015417 January 18, 2000 Reynolds, Jr.
6017322 January 25, 2000 Snoke et al.
6017354 January 25, 2000 Culp et al.
6017356 January 25, 2000 Frederick et al.
6018227 January 25, 2000 Kumar et al.
6022352 February 8, 2000 Vandewalle
6024741 February 15, 2000 Williamson, IV et al.
6024748 February 15, 2000 Manzo et al.
6024764 February 15, 2000 Schroeppel
6027501 February 22, 2000 Goble et al.
6032849 March 7, 2000 Mastri et al.
6033378 March 7, 2000 Lundquist et al.
6033399 March 7, 2000 Gines
6033427 March 7, 2000 Lee
6037724 March 14, 2000 Buss et al.
6037927 March 14, 2000 Rosenberg
6039733 March 21, 2000 Buysse et al.
6039734 March 21, 2000 Goble
6042601 March 28, 2000 Smith
6045560 April 4, 2000 McKean et al.
6047861 April 11, 2000 Vidal et al.
6049145 April 11, 2000 Austin et al.
6050472 April 18, 2000 Shibata
6050990 April 18, 2000 Tankovich et al.
6050996 April 18, 2000 Schmaltz et al.
6053390 April 25, 2000 Green et al.
6053922 April 25, 2000 Krause et al.
RE36720 May 30, 2000 Green et al.
6056735 May 2, 2000 Okada et al.
6056746 May 2, 2000 Goble et al.
6062360 May 16, 2000 Shields
6063095 May 16, 2000 Wang et al.
6063097 May 16, 2000 Oi et al.
6063098 May 16, 2000 Houser et al.
6065679 May 23, 2000 Levie et al.
6065919 May 23, 2000 Peck
6066132 May 23, 2000 Chen et al.
6068627 May 30, 2000 Orszulak et al.
6071233 June 6, 2000 Ishikawa et al.
6074386 June 13, 2000 Goble et al.
6074401 June 13, 2000 Gardiner et al.
6077286 June 20, 2000 Cuschieri et al.
6079606 June 27, 2000 Milliman et al.
6080181 June 27, 2000 Jensen et al.
6082577 July 4, 2000 Coates et al.
6083191 July 4, 2000 Rose
6083234 July 4, 2000 Nicholas et al.
6083242 July 4, 2000 Cook
6086544 July 11, 2000 Hibner et al.
6086600 July 11, 2000 Kortenbach
6090106 July 18, 2000 Goble et al.
6093186 July 25, 2000 Goble
6099537 August 8, 2000 Sugai et al.
6099551 August 8, 2000 Gabbay
6102271 August 15, 2000 Longo et al.
6104304 August 15, 2000 Clark et al.
6106511 August 22, 2000 Jensen
6109500 August 29, 2000 Alli et al.
6117148 September 12, 2000 Ravo et al.
6117158 September 12, 2000 Measamer et al.
6119913 September 19, 2000 Adams et al.
6120433 September 19, 2000 Mizuno et al.
6120462 September 19, 2000 Hibner et al.
6123241 September 26, 2000 Walter et al.
H1904 October 3, 2000 Yates et al.
6126058 October 3, 2000 Adams et al.
6126359 October 3, 2000 Dittrich et al.
6126670 October 3, 2000 Walker et al.
6131789 October 17, 2000 Schulze et al.
6131790 October 17, 2000 Piraka
6132368 October 17, 2000 Cooper
6139546 October 31, 2000 Koenig et al.
6149660 November 21, 2000 Laufer et al.
6152935 November 28, 2000 Kammerer et al.
6155473 December 5, 2000 Tompkins et al.
6156056 December 5, 2000 Kearns et al.
6159146 December 12, 2000 El Gazayerli
6159200 December 12, 2000 Verdura et al.
6159224 December 12, 2000 Yoon
6162208 December 19, 2000 Hipps
6162537 December 19, 2000 Martin et al.
6165175 December 26, 2000 Wampler et al.
6165184 December 26, 2000 Verdura et al.
6165188 December 26, 2000 Saadat et al.
6168605 January 2, 2001 Measamer et al.
6171305 January 9, 2001 Sherman
6171316 January 9, 2001 Kovac et al.
6171330 January 9, 2001 Benchetrit
6174308 January 16, 2001 Goble et al.
6174309 January 16, 2001 Wrublewski et al.
6175290 January 16, 2001 Forsythe et al.
6179195 January 30, 2001 Adams et al.
6179776 January 30, 2001 Adams et al.
6181105 January 30, 2001 Cutolo et al.
6182673 February 6, 2001 Kindermann et al.
6187003 February 13, 2001 Buysse et al.
6190386 February 20, 2001 Rydell
6193129 February 27, 2001 Bittner et al.
6197042 March 6, 2001 Ginn et al.
6200330 March 13, 2001 Benderev et al.
6202914 March 20, 2001 Geiste et al.
6206897 March 27, 2001 Jamiolkowski et al.
6206904 March 27, 2001 Ouchi
6210403 April 3, 2001 Klicek
6213999 April 10, 2001 Platt, Jr. et al.
6214028 April 10, 2001 Yoon et al.
6220368 April 24, 2001 Ark et al.
6223100 April 24, 2001 Green
6223835 May 1, 2001 Habedank et al.
6224617 May 1, 2001 Saadat et al.
6228081 May 8, 2001 Goble
6228083 May 8, 2001 Lands et al.
6228084 May 8, 2001 Kirwan, Jr.
6231565 May 15, 2001 Tovey et al.
6234178 May 22, 2001 Goble et al.
6241139 June 5, 2001 Milliman et al.
6241140 June 5, 2001 Adams et al.
6241723 June 5, 2001 Heim et al.
6245084 June 12, 2001 Mark et al.
6248116 June 19, 2001 Chevillon et al.
6248117 June 19, 2001 Blatter
6249076 June 19, 2001 Madden et al.
6249105 June 19, 2001 Andrews et al.
6250532 June 26, 2001 Green et al.
6258107 July 10, 2001 Balázs et al.
6261286 July 17, 2001 Goble et al.
6264086 July 24, 2001 McGuckin, Jr.
6264087 July 24, 2001 Whitman
6270508 August 7, 2001 Klieman et al.
6273876 August 14, 2001 Klima et al.
6273897 August 14, 2001 Dalessandro et al.
6277114 August 21, 2001 Bullivant et al.
6293942 September 25, 2001 Goble et al.
6296640 October 2, 2001 Wampler et al.
6302311 October 16, 2001 Adams et al.
6305891 October 23, 2001 Burlingame
6306134 October 23, 2001 Goble et al.
6306149 October 23, 2001 Meade
6309403 October 30, 2001 Minor et al.
6315184 November 13, 2001 Whitman
6320123 November 20, 2001 Reimers
6322494 November 27, 2001 Bullivant et al.
6324339 November 27, 2001 Hudson et al.
6325799 December 4, 2001 Goble
6325810 December 4, 2001 Hamilton et al.
6330965 December 18, 2001 Milliman et al.
6331181 December 18, 2001 Tierney et al.
6331761 December 18, 2001 Kumar et al.
6333029 December 25, 2001 Vyakarnam et al.
6334860 January 1, 2002 Dorn
6334861 January 1, 2002 Chandler et al.
6336926 January 8, 2002 Goble
6338737 January 15, 2002 Toledano
6343731 February 5, 2002 Adams et al.
6346077 February 12, 2002 Taylor et al.
6352503 March 5, 2002 Matsui et al.
6352532 March 5, 2002 Kramer et al.
6355699 March 12, 2002 Vyakarnam et al.
6356072 March 12, 2002 Chass
6358224 March 19, 2002 Tims et al.
6364877 April 2, 2002 Goble et al.
6364888 April 2, 2002 Niemeyer et al.
6370981 April 16, 2002 Watarai
6373152 April 16, 2002 Wang et al.
6383201 May 7, 2002 Dong
6387113 May 14, 2002 Hawkins et al.
6387114 May 14, 2002 Adams
6391038 May 21, 2002 Vargas et al.
6392854 May 21, 2002 O'Gorman
6398781 June 4, 2002 Goble et al.
6398797 June 4, 2002 Bombard et al.
6402766 June 11, 2002 Bowman et al.
6406440 June 18, 2002 Stefanchik
6406472 June 18, 2002 Jensen
6409724 June 25, 2002 Penny et al.
H2037 July 2, 2002 Yates et al.
6413274 July 2, 2002 Pedros
6416486 July 9, 2002 Wampler
6416509 July 9, 2002 Goble et al.
6419695 July 16, 2002 Gabbay
6423079 July 23, 2002 Blake, III
RE37814 August 6, 2002 Allgeyer
6428070 August 6, 2002 Takanashi et al.
6429611 August 6, 2002 Li
6430298 August 6, 2002 Kettl et al.
6432065 August 13, 2002 Burdorff et al.
6436097 August 20, 2002 Nardella
6436107 August 20, 2002 Wang et al.
6436110 August 20, 2002 Bowman et al.
6436122 August 20, 2002 Frank et al.
6439439 August 27, 2002 Rickard et al.
6439446 August 27, 2002 Perry et al.
6440146 August 27, 2002 Nicholas et al.
6441577 August 27, 2002 Blumenkranz et al.
6443973 September 3, 2002 Whitman
6447518 September 10, 2002 Krause et al.
6447864 September 10, 2002 Johnson et al.
6450391 September 17, 2002 Kayan et al.
6450989 September 17, 2002 Dubrul et al.
6454781 September 24, 2002 Witt et al.
6468275 October 22, 2002 Wampler et al.
6471106 October 29, 2002 Reining
6471659 October 29, 2002 Eggers et al.
6478210 November 12, 2002 Adams et al.
6482200 November 19, 2002 Shippert
6485490 November 26, 2002 Wampler et al.
6485667 November 26, 2002 Tan
6488196 December 3, 2002 Fenton, Jr.
6488197 December 3, 2002 Whitman
6491201 December 10, 2002 Whitman
6491690 December 10, 2002 Goble et al.
6491701 December 10, 2002 Tierney et al.
6492785 December 10, 2002 Kasten et al.
6494896 December 17, 2002 D'Alessio et al.
6498480 December 24, 2002 Manara
6500176 December 31, 2002 Truckai et al.
6500194 December 31, 2002 Benderev et al.
6503257 January 7, 2003 Grant et al.
6503259 January 7, 2003 Huxel et al.
6505768 January 14, 2003 Whitman
6510854 January 28, 2003 Goble
6511468 January 28, 2003 Cragg et al.
6512360 January 28, 2003 Goto et al.
6517528 February 11, 2003 Pantages et al.
6517535 February 11, 2003 Edwards
6517565 February 11, 2003 Whitman et al.
6517566 February 11, 2003 Hovland et al.
6522101 February 18, 2003 Malackowski
6527782 March 4, 2003 Hogg et al.
6527785 March 4, 2003 Sancoff et al.
6533157 March 18, 2003 Whitman
6533784 March 18, 2003 Truckai et al.
6535764 March 18, 2003 Imran et al.
6543456 April 8, 2003 Freeman
6545384 April 8, 2003 Pelrine et al.
6547786 April 15, 2003 Goble
6550546 April 22, 2003 Thurler et al.
6551333 April 22, 2003 Kuhns et al.
6554861 April 29, 2003 Knox et al.
6555770 April 29, 2003 Kawase
6558378 May 6, 2003 Sherman et al.
6558379 May 6, 2003 Batchelor et al.
6565560 May 20, 2003 Goble et al.
6566619 May 20, 2003 Gillman et al.
6569085 May 27, 2003 Kortenbach et al.
6569171 May 27, 2003 DeGuillebon et al.
6578751 June 17, 2003 Hartwick
6582427 June 24, 2003 Goble et al.
6582441 June 24, 2003 He et al.
6583533 June 24, 2003 Pelrine et al.
6585144 July 1, 2003 Adams et al.
6587750 July 1, 2003 Gerbi et al.
6588643 July 8, 2003 Bolduc et al.
6588931 July 8, 2003 Betzner et al.
6589164 July 8, 2003 Flaherty
6592538 July 15, 2003 Hotchkiss et al.
6592597 July 15, 2003 Grant et al.
6596296 July 22, 2003 Nelson et al.
6596304 July 22, 2003 Bayon et al.
6596432 July 22, 2003 Kawakami et al.
D478665 August 19, 2003 Isaacs et al.
D478986 August 26, 2003 Johnston et al.
6601749 August 5, 2003 Sullivan et al.
6602252 August 5, 2003 Mollenauer
6602262 August 5, 2003 Griego et al.
6605078 August 12, 2003 Adams
6605669 August 12, 2003 Awokola et al.
6607475 August 19, 2003 Doyle et al.
6611793 August 26, 2003 Burnside et al.
6613069 September 2, 2003 Boyd et al.
6616686 September 9, 2003 Coleman et al.
6619529 September 16, 2003 Green et al.
6620166 September 16, 2003 Wenstrom, Jr. et al.
6626834 September 30, 2003 Dunne et al.
6629630 October 7, 2003 Adams
6629974 October 7, 2003 Penny et al.
6629988 October 7, 2003 Weadock
6635838 October 21, 2003 Kornelson
6636412 October 21, 2003 Smith
6638108 October 28, 2003 Tachi
6638285 October 28, 2003 Gabbay
6638297 October 28, 2003 Huitema
RE38335 November 25, 2003 Aust et al.
6641528 November 4, 2003 Torii
6644532 November 11, 2003 Green et al.
6645201 November 11, 2003 Utley et al.
6646307 November 11, 2003 Yu et al.
6648816 November 18, 2003 Irion et al.
6652595 November 25, 2003 Nicolo
D484243 December 23, 2003 Ryan et al.
D484595 December 30, 2003 Ryan et al.
D484596 December 30, 2003 Ryan et al.
6656177 December 2, 2003 Truckai et al.
6656193 December 2, 2003 Grant et al.
6663623 December 16, 2003 Oyama et al.
6663641 December 16, 2003 Kovac et al.
6666854 December 23, 2003 Lange
6666875 December 23, 2003 Sakurai et al.
6667825 December 23, 2003 Lu et al.
6669073 December 30, 2003 Milliman et al.
6671185 December 30, 2003 Duval
D484977 January 6, 2004 Ryan et al.
6676660 January 13, 2004 Wampler et al.
6679269 January 20, 2004 Swanson
6679410 January 20, 2004 Würsch et al.
6681978 January 27, 2004 Geiste et al.
6681979 January 27, 2004 Whitman
6682527 January 27, 2004 Strul
6682528 January 27, 2004 Frazier et al.
6685727 February 3, 2004 Fisher et al.
6689153 February 10, 2004 Skiba
6692507 February 17, 2004 Pugsley et al.
6695198 February 24, 2004 Adams et al.
6695199 February 24, 2004 Whitman
6695774 February 24, 2004 Hale et al.
6697048 February 24, 2004 Rosenberg et al.
6698643 March 2, 2004 Whitman
6699235 March 2, 2004 Wallace et al.
6704210 March 9, 2004 Myers
6705503 March 16, 2004 Pedicini et al.
6709445 March 23, 2004 Boebel et al.
6712773 March 30, 2004 Viola
6716223 April 6, 2004 Leopold et al.
6716232 April 6, 2004 Vidal et al.
6716233 April 6, 2004 Whitman
6722552 April 20, 2004 Fenton, Jr.
6723087 April 20, 2004 O'Neill et al.
6723091 April 20, 2004 Goble et al.
6726697 April 27, 2004 Nicholas et al.
6726706 April 27, 2004 Dominguez
6729119 May 4, 2004 Schnipke et al.
6736825 May 18, 2004 Blatter et al.
6736854 May 18, 2004 Vadurro et al.
6740030 May 25, 2004 Martone et al.
6747121 June 8, 2004 Gogolewski
6749560 June 15, 2004 Konstorum et al.
6752768 June 22, 2004 Burdorff et al.
6752816 June 22, 2004 Culp et al.
6755195 June 29, 2004 Lemke et al.
6755338 June 29, 2004 Hahnen et al.
6758846 July 6, 2004 Goble et al.
6761685 July 13, 2004 Adams et al.
6762339 July 13, 2004 Klun et al.
6764445 July 20, 2004 Ramans et al.
6767352 July 27, 2004 Field et al.
6767356 July 27, 2004 Kanner et al.
6769590 August 3, 2004 Vresh et al.
6769594 August 3, 2004 Orban, III
6770027 August 3, 2004 Banik et al.
6770070 August 3, 2004 Balbierz
6770072 August 3, 2004 Truckai et al.
6773409 August 10, 2004 Truckai et al.
6773438 August 10, 2004 Knodel et al.
6775575 August 10, 2004 Bommannan et al.
6777838 August 17, 2004 Miekka et al.
6780151 August 24, 2004 Grabover et al.
6780180 August 24, 2004 Goble et al.
6783524 August 31, 2004 Anderson et al.
6786382 September 7, 2004 Hoffman
6786864 September 7, 2004 Matsuura et al.
6786896 September 7, 2004 Madani et al.
6788018 September 7, 2004 Blumenkranz
6790173 September 14, 2004 Saadat et al.
6793652 September 21, 2004 Whitman et al.
6793661 September 21, 2004 Hamilton et al.
6793663 September 21, 2004 Kneifel et al.
6802843 October 12, 2004 Truckai et al.
6805273 October 19, 2004 Bilotti et al.
6806808 October 19, 2004 Watters et al.
6808525 October 26, 2004 Latterell et al.
6814741 November 9, 2004 Bowman et al.
6817508 November 16, 2004 Racenet et al.
6817509 November 16, 2004 Geiste et al.
6817974 November 16, 2004 Cooper et al.
6818018 November 16, 2004 Sawhney
6820791 November 23, 2004 Adams
6821273 November 23, 2004 Mollenauer
6821282 November 23, 2004 Perry et al.
6821284 November 23, 2004 Sturtz et al.
6827246 December 7, 2004 Sullivan et al.
6827712 December 7, 2004 Tovey et al.
6827725 December 7, 2004 Batchelor et al.
6828902 December 7, 2004 Casden
6830174 December 14, 2004 Hillstead et al.
6831629 December 14, 2004 Nishino et al.
6832998 December 21, 2004 Goble
6834001 December 21, 2004 Myono
6835173 December 28, 2004 Couvillon, Jr.
6835199 December 28, 2004 McGuckin, Jr. et al.
6835336 December 28, 2004 Watt
6837846 January 4, 2005 Jaffe et al.
6837883 January 4, 2005 Moll et al.
6838493 January 4, 2005 Williams et al.
6840423 January 11, 2005 Adams et al.
6843403 January 18, 2005 Whitman
6843789 January 18, 2005 Goble
6843793 January 18, 2005 Brock et al.
6846307 January 25, 2005 Whitman et al.
6846308 January 25, 2005 Whitman et al.
6846309 January 25, 2005 Whitman et al.
6849071 February 1, 2005 Whitman et al.
6850817 February 1, 2005 Green
6853879 February 8, 2005 Sunaoshi
6858005 February 22, 2005 Ohline et al.
RE38708 March 1, 2005 Bolanos et al.
6861142 March 1, 2005 Wilkie et al.
6863694 March 8, 2005 Boyce et al.
6866178 March 15, 2005 Adams et al.
6866671 March 15, 2005 Tierney et al.
6867248 March 15, 2005 Martin et al.
6869430 March 22, 2005 Balbierz et al.
6869435 March 22, 2005 Blake, III
6872214 March 29, 2005 Sonnenschein et al.
6874669 April 5, 2005 Adams et al.
6877647 April 12, 2005 Green et al.
6878106 April 12, 2005 Herrmann
6889116 May 3, 2005 Jinno
6893435 May 17, 2005 Goble
6899538 May 31, 2005 Matoba
6905057 June 14, 2005 Swayze et al.
6905497 June 14, 2005 Truckai et al.
6905498 June 14, 2005 Hooven
6908472 June 21, 2005 Wiener et al.
6911033 June 28, 2005 de Guillebon et al.
6911916 June 28, 2005 Wang et al.
6913579 July 5, 2005 Truckai et al.
6913608 July 5, 2005 Liddicoat et al.
6913613 July 5, 2005 Schwarz et al.
6921397 July 26, 2005 Corcoran et al.
6921412 July 26, 2005 Black et al.
6923093 August 2, 2005 Ullah
6923803 August 2, 2005 Goble
6926716 August 9, 2005 Baker et al.
6929641 August 16, 2005 Goble et al.
6929644 August 16, 2005 Truckai et al.
6931830 August 23, 2005 Liao
6932218 August 23, 2005 Kosann et al.
6932810 August 23, 2005 Ryan
6936042 August 30, 2005 Wallace et al.
6936948 August 30, 2005 Bell et al.
6939358 September 6, 2005 Palacios et al.
6942662 September 13, 2005 Goble et al.
6945444 September 20, 2005 Gresham et al.
6945981 September 20, 2005 Donofrio et al.
6953138 October 11, 2005 Dworak et al.
6953139 October 11, 2005 Milliman et al.
6958035 October 25, 2005 Friedman et al.
6959851 November 1, 2005 Heinrich
6959852 November 1, 2005 Shelton, IV et al.
6960107 November 1, 2005 Schaub et al.
6960163 November 1, 2005 Ewers et al.
6960220 November 1, 2005 Marino et al.
6962587 November 8, 2005 Johnson et al.
6963792 November 8, 2005 Green
6964363 November 15, 2005 Wales et al.
6966907 November 22, 2005 Goble
6966909 November 22, 2005 Marshall et al.
6971988 December 6, 2005 Orban, III
6972199 December 6, 2005 Lebouitz et al.
6974462 December 13, 2005 Sater
6978921 December 27, 2005 Shelton, IV et al.
6978922 December 27, 2005 Bilotti et al.
6981628 January 3, 2006 Wales
6981941 January 3, 2006 Whitman et al.
6981978 January 3, 2006 Gannoe
6984203 January 10, 2006 Tartaglia et al.
6984231 January 10, 2006 Goble et al.
6986451 January 17, 2006 Mastri et al.
6988649 January 24, 2006 Shelton, IV et al.
6988650 January 24, 2006 Schwemberger et al.
6990796 January 31, 2006 Schnipke et al.
6993413 January 31, 2006 Sunaoshi
6994708 February 7, 2006 Manzo
6995729 February 7, 2006 Govari et al.
6997931 February 14, 2006 Sauer et al.
6998736 February 14, 2006 Lee et al.
6998816 February 14, 2006 Wieck et al.
7000818 February 21, 2006 Shelton, IV et al.
7000819 February 21, 2006 Swayze et al.
7001380 February 21, 2006 Goble
7001408 February 21, 2006 Knodel et al.
7008435 March 7, 2006 Cummins
7009039 March 7, 2006 Yayon et al.
7011657 March 14, 2006 Truckai et al.
7018357 March 28, 2006 Emmons
7018390 March 28, 2006 Turovskiy et al.
7021669 April 4, 2006 Lindermeir et al.
7025743 April 11, 2006 Mann et al.
7029435 April 18, 2006 Nakao
7029439 April 18, 2006 Roberts et al.
7032798 April 25, 2006 Whitman et al.
7032799 April 25, 2006 Viola et al.
7033356 April 25, 2006 Latterell et al.
7036680 May 2, 2006 Flannery
7037344 May 2, 2006 Kagan et al.
7041102 May 9, 2006 Truckai et al.
7041868 May 9, 2006 Greene et al.
7043852 May 16, 2006 Hayashida et al.
7044350 May 16, 2006 Kameyama et al.
7044352 May 16, 2006 Shelton, IV et al.
7044353 May 16, 2006 Mastri et al.
7048687 May 23, 2006 Reuss et al.
7048745 May 23, 2006 Tierney et al.
7052494 May 30, 2006 Goble et al.
7052499 May 30, 2006 Steger et al.
7055730 June 6, 2006 Ehrenfels et al.
7055731 June 6, 2006 Shelton, IV et al.
7056284 June 6, 2006 Martone et al.
7056330 June 6, 2006 Gayton
7059331 June 13, 2006 Adams et al.
7059508 June 13, 2006 Shelton, IV et al.
7063671 June 20, 2006 Couvillon, Jr.
7063712 June 20, 2006 Vargas et al.
7066879 June 27, 2006 Fowler et al.
7066944 June 27, 2006 Laufer et al.
7067038 June 27, 2006 Trokhan et al.
7070083 July 4, 2006 Jankowski
7070559 July 4, 2006 Adams et al.
7070597 July 4, 2006 Truckai et al.
7071287 July 4, 2006 Rhine et al.
7075770 July 11, 2006 Smith
7077856 July 18, 2006 Whitman
7080769 July 25, 2006 Vresh et al.
7081114 July 25, 2006 Rashidi
7083073 August 1, 2006 Yoshie et al.
7083075 August 1, 2006 Swayze et al.
7083571 August 1, 2006 Wang et al.
7083615 August 1, 2006 Peterson et al.
7083619 August 1, 2006 Truckai et al.
7083620 August 1, 2006 Jahns et al.
7087054 August 8, 2006 Truckai et al.
7087071 August 8, 2006 Nicholas et al.
7090637 August 15, 2006 Danitz et al.
7090673 August 15, 2006 Dycus et al.
7090683 August 15, 2006 Brock et al.
7090684 August 15, 2006 McGuckin, Jr. et al.
7094202 August 22, 2006 Nobis et al.
7094247 August 22, 2006 Monassevitch et al.
7097089 August 29, 2006 Marczyk
7097644 August 29, 2006 Long
7097650 August 29, 2006 Weller et al.
7098794 August 29, 2006 Lindsay et al.
7100949 September 5, 2006 Williams et al.
7101394 September 5, 2006 Hamm et al.
7104741 September 12, 2006 Krohn
7108695 September 19, 2006 Witt et al.
7108701 September 19, 2006 Evens et al.
7108709 September 19, 2006 Cummins
7111769 September 26, 2006 Wales et al.
7112214 September 26, 2006 Peterson et al.
RE39358 October 17, 2006 Goble
7114642 October 3, 2006 Whitman
7118582 October 10, 2006 Wang et al.
7121446 October 17, 2006 Arad et al.
7122028 October 17, 2006 Looper et al.
7125409 October 24, 2006 Truckai et al.
7126303 October 24, 2006 Farritor et al.
7126879 October 24, 2006 Snyder
7128253 October 31, 2006 Mastri et al.
7128254 October 31, 2006 Shelton, IV et al.
7128748 October 31, 2006 Mooradian et al.
7131445 November 7, 2006 Amoah
7133601 November 7, 2006 Phillips et al.
7134587 November 14, 2006 Schwemberger et al.
7137980 November 21, 2006 Buysse et al.
7137981 November 21, 2006 Long
7139016 November 21, 2006 Squilla et al.
7140527 November 28, 2006 Ehrenfels et al.
7140528 November 28, 2006 Shelton, IV
7143923 December 5, 2006 Shelton, IV et al.
7143924 December 5, 2006 Scirica et al.
7143925 December 5, 2006 Shelton, IV et al.
7143926 December 5, 2006 Shelton, IV et al.
7147138 December 12, 2006 Shelton, IV
7147139 December 12, 2006 Schwemberger et al.
7147140 December 12, 2006 Wukusick et al.
7147637 December 12, 2006 Goble
7147650 December 12, 2006 Lee
7150748 December 19, 2006 Ebbutt et al.
7153300 December 26, 2006 Goble
7155316 December 26, 2006 Sutherland et al.
7156863 January 2, 2007 Sonnenschein et al.
7159750 January 9, 2007 Racenet et al.
7160296 January 9, 2007 Pearson et al.
7160299 January 9, 2007 Baily
7161036 January 9, 2007 Oikawa et al.
7166133 January 23, 2007 Evans et al.
7168604 January 30, 2007 Milliman et al.
7171279 January 30, 2007 Buckingham et al.
7172104 February 6, 2007 Scirica et al.
7172593 February 6, 2007 Trieu et al.
7179223 February 20, 2007 Motoki et al.
7179267 February 20, 2007 Nolan et al.
7182239 February 27, 2007 Myers
7182763 February 27, 2007 Nardella
7183737 February 27, 2007 Kitagawa
7188758 March 13, 2007 Viola et al.
7189207 March 13, 2007 Viola
7195627 March 27, 2007 Amoah et al.
7199537 April 3, 2007 Okamura et al.
7202653 April 10, 2007 Pai
7204835 April 17, 2007 Latterell et al.
7207233 April 24, 2007 Wadge
7207471 April 24, 2007 Heinrich et al.
7207472 April 24, 2007 Wukusick et al.
7207556 April 24, 2007 Saitoh et al.
7208005 April 24, 2007 Frecker et al.
7210609 May 1, 2007 Leiboff et al.
7211081 May 1, 2007 Goble
7211084 May 1, 2007 Goble et al.
7211092 May 1, 2007 Hughett
7211979 May 1, 2007 Khatib et al.
7213736 May 8, 2007 Wales et al.
7214224 May 8, 2007 Goble
7215517 May 8, 2007 Takamatsu
7217285 May 15, 2007 Vargas et al.
7220260 May 22, 2007 Fleming et al.
7220272 May 22, 2007 Weadock
7225963 June 5, 2007 Scirica
7225964 June 5, 2007 Mastri et al.
7234624 June 26, 2007 Gresham et al.
7235089 June 26, 2007 McGuckin, Jr.
7235302 June 26, 2007 Jing et al.
7237708 July 3, 2007 Guy et al.
7238195 July 3, 2007 Viola
7238901 July 3, 2007 Kim et al.
7241288 July 10, 2007 Braun
7246734 July 24, 2007 Shelton, IV
7247161 July 24, 2007 Johnston et al.
7249267 July 24, 2007 Chapius
7252660 August 7, 2007 Kunz
7255696 August 14, 2007 Goble et al.
7256695 August 14, 2007 Hamel et al.
7258262 August 21, 2007 Mastri et al.
7258546 August 21, 2007 Beier et al.
7260431 August 21, 2007 Libbus et al.
7265374 September 4, 2007 Lee et al.
7267679 September 11, 2007 McGuckin, Jr. et al.
7273483 September 25, 2007 Wiener et al.
7278562 October 9, 2007 Mastri et al.
7278563 October 9, 2007 Green
7278949 October 9, 2007 Bader
7278994 October 9, 2007 Goble
7282048 October 16, 2007 Goble et al.
7286850 October 23, 2007 Frielink et al.
7287682 October 30, 2007 Ezzat et al.
7293685 November 13, 2007 Ehrenfels et al.
7295893 November 13, 2007 Sunaoshi
7295907 November 13, 2007 Lu et al.
7296722 November 20, 2007 Ivanko
7296724 November 20, 2007 Green et al.
7297149 November 20, 2007 Vitali et al.
7300373 November 27, 2007 Jinno et al.
7300450 November 27, 2007 Vleugels et al.
7303106 December 4, 2007 Milliman et al.
7303107 December 4, 2007 Milliman et al.
7303108 December 4, 2007 Shelton, IV
7303502 December 4, 2007 Thompson
7303556 December 4, 2007 Metzger
7306597 December 11, 2007 Manzo
7308998 December 18, 2007 Mastri et al.
7322859 January 29, 2008 Evans
7322975 January 29, 2008 Goble et al.
7322994 January 29, 2008 Nicholas et al.
7324572 January 29, 2008 Chang
7326203 February 5, 2008 Papineau et al.
7326213 February 5, 2008 Benderev et al.
7328828 February 12, 2008 Ortiz et al.
7328829 February 12, 2008 Arad et al.
7330004 February 12, 2008 DeJonge et al.
7331340 February 19, 2008 Barney
7334717 February 26, 2008 Rethy et al.
7334718 February 26, 2008 McAlister et al.
7335199 February 26, 2008 Goble et al.
7336048 February 26, 2008 Lohr
7336184 February 26, 2008 Smith et al.
7338513 March 4, 2008 Lee et al.
7341591 March 11, 2008 Grinberg
7343920 March 18, 2008 Toby et al.
7344532 March 18, 2008 Goble et al.
7344533 March 18, 2008 Pearson et al.
7346344 March 18, 2008 Fontaine
7348763 March 25, 2008 Reinhart et al.
RE40237 April 15, 2008 Bilotti et al.
7351258 April 1, 2008 Ricotta et al.
7354447 April 8, 2008 Shelton, IV et al.
7354502 April 8, 2008 Polat et al.
7357287 April 15, 2008 Shelton, IV et al.
7357806 April 15, 2008 Rivera et al.
7361195 April 22, 2008 Schwartz et al.
7364060 April 29, 2008 Milliman
7364061 April 29, 2008 Swayze et al.
7377918 May 27, 2008 Amoah
7377928 May 27, 2008 Zubik et al.
7380695 June 3, 2008 Doll et al.
7380696 June 3, 2008 Shelton, IV et al.
7384417 June 10, 2008 Cucin
7386365 June 10, 2008 Nixon
7386730 June 10, 2008 Uchikubo
7388217 June 17, 2008 Buschbeck et al.
7388484 June 17, 2008 Hsu
7391173 June 24, 2008 Schena
7396356 July 8, 2008 Mollenauer
7397364 July 8, 2008 Govari
7398907 July 15, 2008 Racenet et al.
7398908 July 15, 2008 Holsten et al.
7400752 July 15, 2008 Zacharias
7401721 July 22, 2008 Holsten et al.
7404508 July 29, 2008 Smith et al.
7404509 July 29, 2008 Ortiz et al.
7404822 July 29, 2008 Viart et al.
7407074 August 5, 2008 Ortiz et al.
7407075 August 5, 2008 Holsten et al.
7407076 August 5, 2008 Racenet et al.
7407077 August 5, 2008 Ortiz et al.
7407078 August 5, 2008 Shelton, IV et al.
7410086 August 12, 2008 Ortiz et al.
7413563 August 19, 2008 Corcoran et al.
7416101 August 26, 2008 Shelton, IV et al.
7418078 August 26, 2008 Blanz et al.
RE40514 September 23, 2008 Mastri et al.
7419080 September 2, 2008 Smith et al.
7419081 September 2, 2008 Ehrenfels et al.
7419495 September 2, 2008 Menn et al.
7422136 September 9, 2008 Marczyk
7422138 September 9, 2008 Bilotti et al.
7422139 September 9, 2008 Shelton, IV et al.
7424965 September 16, 2008 Racenet et al.
7427607 September 23, 2008 Suzuki
7431188 October 7, 2008 Marczyk
7431189 October 7, 2008 Shelton, IV et al.
7431694 October 7, 2008 Stefanchik et al.
7431730 October 7, 2008 Viola
7434715 October 14, 2008 Shelton, IV et al.
7434717 October 14, 2008 Shelton, IV et al.
7438209 October 21, 2008 Hess et al.
7438718 October 21, 2008 Milliman et al.
7439354 October 21, 2008 Lenges et al.
7441684 October 28, 2008 Shelton, IV et al.
7441685 October 28, 2008 Boudreaux
7442201 October 28, 2008 Pugsley et al.
7443547 October 28, 2008 Moreno et al.
7448525 November 11, 2008 Shelton, IV et al.
7451904 November 18, 2008 Shelton, IV
7455208 November 25, 2008 Wales et al.
7455676 November 25, 2008 Holsten et al.
7455682 November 25, 2008 Viola
7461767 December 9, 2008 Viola et al.
7462187 December 9, 2008 Johnston et al.
7464846 December 16, 2008 Shelton, IV et al.
7464847 December 16, 2008 Viola et al.
7464849 December 16, 2008 Shelton, IV et al.
7467740 December 23, 2008 Shelton, IV et al.
7467849 December 23, 2008 Silverbrook et al.
7472814 January 6, 2009 Mastri et al.
7472815 January 6, 2009 Shelton, IV et al.
7472816 January 6, 2009 Holsten et al.
7473253 January 6, 2009 Dycus et al.
7473263 January 6, 2009 Johnston et al.
7476237 January 13, 2009 Taniguchi et al.
7479608 January 20, 2009 Smith
7481347 January 27, 2009 Roy
7481348 January 27, 2009 Marczyk
7481349 January 27, 2009 Holsten et al.
7481824 January 27, 2009 Boudreaux et al.
7485133 February 3, 2009 Cannon et al.
7485142 February 3, 2009 Milo
7487899 February 10, 2009 Shelton, IV et al.
7490749 February 17, 2009 Schall et al.
7494039 February 24, 2009 Racenet et al.
7494499 February 24, 2009 Nagase et al.
7494501 February 24, 2009 Ahlberg et al.
7500979 March 10, 2009 Hueil et al.
7501198 March 10, 2009 Barley et al.
7503474 March 17, 2009 Hillstead et al.
7506790 March 24, 2009 Shelton, IV
7506791 March 24, 2009 Omaits et al.
7507202 March 24, 2009 Schoellhorn
7510107 March 31, 2009 Timm et al.
7510566 March 31, 2009 Jacobs et al.
7513408 April 7, 2009 Shelton, IV et al.
7517356 April 14, 2009 Heinrich
7524320 April 28, 2009 Tierney et al.
7530984 May 12, 2009 Sonnenschein et al.
7530985 May 12, 2009 Takemoto et al.
7533906 May 19, 2009 Luettgen et al.
7534259 May 19, 2009 Lashinski et al.
7540867 June 2, 2009 Jinno et al.
7542807 June 2, 2009 Bertolero et al.
7546939 June 16, 2009 Adams et al.
7546940 June 16, 2009 Milliman et al.
7547312 June 16, 2009 Bauman et al.
7549563 June 23, 2009 Mather et al.
7549564 June 23, 2009 Boudreaux
7549998 June 23, 2009 Braun
7552854 June 30, 2009 Wixey et al.
7553173 June 30, 2009 Kowalick
7556185 July 7, 2009 Viola
7556186 July 7, 2009 Milliman
7556647 July 7, 2009 Drews et al.
7559449 July 14, 2009 Viola
7559450 July 14, 2009 Wales et al.
7559452 July 14, 2009 Wales et al.
7559937 July 14, 2009 de la Torre et al.
7562910 July 21, 2009 Kertesz et al.
7563862 July 21, 2009 Sieg et al.
7565993 July 28, 2009 Milliman et al.
7566300 July 28, 2009 Devierre et al.
7567045 July 28, 2009 Fristedt
7568603 August 4, 2009 Shelton, IV et al.
7568604 August 4, 2009 Ehrenfels et al.
7568619 August 4, 2009 Todd et al.
7575144 August 18, 2009 Ortiz et al.
7583063 September 1, 2009 Dooley
7588174 September 15, 2009 Holsten et al.
7588175 September 15, 2009 Timm et al.
7588176 September 15, 2009 Timm et al.
7588177 September 15, 2009 Racenet
7591783 September 22, 2009 Boulais et al.
7591818 September 22, 2009 Bertolero et al.
7597229 October 6, 2009 Boudreaux et al.
7597230 October 6, 2009 Racenet et al.
7597693 October 6, 2009 Garrison
7600663 October 13, 2009 Green
7604150 October 20, 2009 Boudreaux
7604151 October 20, 2009 Hess et al.
7607557 October 27, 2009 Shelton, IV et al.
7611038 November 3, 2009 Racenet et al.
7611474 November 3, 2009 Hibner et al.
7615003 November 10, 2009 Stefanchik et al.
7615067 November 10, 2009 Lee et al.
7617961 November 17, 2009 Viola
7624902 December 1, 2009 Marczyk et al.
7624903 December 1, 2009 Green et al.
7625370 December 1, 2009 Hart et al.
7631793 December 15, 2009 Rethy et al.
7631794 December 15, 2009 Rethy et al.
7635074 December 22, 2009 Olson et al.
7637409 December 29, 2009 Marczyk
7637410 December 29, 2009 Marczyk
7638958 December 29, 2009 Philipp et al.
7641091 January 5, 2010 Olson et al.
7641092 January 5, 2010 Kruszynski et al.
7641093 January 5, 2010 Doll et al.
7641095 January 5, 2010 Viola
7644783 January 12, 2010 Roberts et al.
7644848 January 12, 2010 Swayze et al.
7645230 January 12, 2010 Mikkaichi et al.
7648519 January 19, 2010 Lee et al.
7650185 January 19, 2010 Maile et al.
7651017 January 26, 2010 Ortiz et al.
7651498 January 26, 2010 Shifrin et al.
7654431 February 2, 2010 Hueil et al.
7655288 February 2, 2010 Bauman et al.
7656131 February 2, 2010 Embrey et al.
7658311 February 9, 2010 Boudreaux
7658312 February 9, 2010 Vidal et al.
7659219 February 9, 2010 Biran et al.
7662161 February 16, 2010 Briganti et al.
7665646 February 23, 2010 Prommersberger
7665647 February 23, 2010 Shelton, IV et al.
7669746 March 2, 2010 Shelton, IV
7669747 March 2, 2010 Weisenburgh, II et al.
7670334 March 2, 2010 Hueil et al.
7673780 March 9, 2010 Shelton, IV et al.
7673781 March 9, 2010 Swayze et al.
7673782 March 9, 2010 Hess et al.
7673783 March 9, 2010 Morgan et al.
7674253 March 9, 2010 Fisher et al.
7674255 March 9, 2010 Braun
7674263 March 9, 2010 Ryan
7674270 March 9, 2010 Layer
7682307 March 23, 2010 Danitz et al.
7682367 March 23, 2010 Shah et al.
7686201 March 30, 2010 Csiky
7686804 March 30, 2010 Johnson et al.
7686826 March 30, 2010 Lee et al.
7688028 March 30, 2010 Phillips et al.
7691098 April 6, 2010 Wallace et al.
7691103 April 6, 2010 Fernandez et al.
7691106 April 6, 2010 Schenberger et al.
7694865 April 13, 2010 Scirica
7695485 April 13, 2010 Whitman et al.
7699204 April 20, 2010 Viola
7699835 April 20, 2010 Lee et al.
7699844 April 20, 2010 Utley et al.
7699846 April 20, 2010 Ryan
7699856 April 20, 2010 Van Wyk et al.
7699859 April 20, 2010 Bombard et al.
7699860 April 20, 2010 Huitema et al.
7703653 April 27, 2010 Shah et al.
7708180 May 4, 2010 Murray et al.
7708181 May 4, 2010 Cole et al.
7708758 May 4, 2010 Lee et al.
7712182 May 11, 2010 Zeiler et al.
7714239 May 11, 2010 Smith
7717312 May 18, 2010 Beetel
7717313 May 18, 2010 Criscuolo et al.
7717846 May 18, 2010 Zirps et al.
7718180 May 18, 2010 Karp
7718556 May 18, 2010 Matsuda et al.
7721930 May 25, 2010 McKenna et al.
7721931 May 25, 2010 Shelton, IV et al.
7721933 May 25, 2010 Ehrenfels et al.
7721934 May 25, 2010 Shelton, IV et al.
7721936 May 25, 2010 Shelton, IV et al.
7722527 May 25, 2010 Bouchier et al.
7722607 May 25, 2010 Dumbauld et al.
7722610 May 25, 2010 Viola et al.
7726537 June 1, 2010 Olson et al.
7726538 June 1, 2010 Holsten et al.
7726539 June 1, 2010 Holsten et al.
7727954 June 1, 2010 McKay
7729742 June 1, 2010 Govari
7731072 June 8, 2010 Timm et al.
7731073 June 8, 2010 Wixey et al.
7731724 June 8, 2010 Huitema et al.
7735703 June 15, 2010 Morgan et al.
7736374 June 15, 2010 Vaughan et al.
7738971 June 15, 2010 Swayze et al.
7740159 June 22, 2010 Shelton, IV et al.
7742036 June 22, 2010 Grant et al.
7743960 June 29, 2010 Whitman et al.
7744624 June 29, 2010 Bettuchi
7744627 June 29, 2010 Orban, III et al.
7744628 June 29, 2010 Viola
7748587 July 6, 2010 Haramiishi et al.
7749204 July 6, 2010 Dhanaraj et al.
7751870 July 6, 2010 Whitman
7753245 July 13, 2010 Boudreaux et al.
7753246 July 13, 2010 Scirica
7753904 July 13, 2010 Shelton, IV et al.
7758612 July 20, 2010 Shipp
7766207 August 3, 2010 Mather et al.
7766209 August 3, 2010 Baxter, III et al.
7766210 August 3, 2010 Shelton, IV et al.
7766821 August 3, 2010 Brunnen et al.
7766894 August 3, 2010 Weitzner et al.
7770773 August 10, 2010 Whitman et al.
7770774 August 10, 2010 Mastri et al.
7770775 August 10, 2010 Shelton, IV et al.
7770776 August 10, 2010 Chen et al.
7771396 August 10, 2010 Stefanchik et al.
7772720 August 10, 2010 McGee et al.
7776037 August 17, 2010 Odom
7776060 August 17, 2010 Mooradian et al.
7778004 August 17, 2010 Nerheim et al.
7780054 August 24, 2010 Wales
7780055 August 24, 2010 Scirica et al.
7780663 August 24, 2010 Yates et al.
7780685 August 24, 2010 Hunt et al.
7784662 August 31, 2010 Wales et al.
7784663 August 31, 2010 Shelton, IV
7787256 August 31, 2010 Chan et al.
7789875 September 7, 2010 Brock et al.
7789883 September 7, 2010 Takashino et al.
7789889 September 7, 2010 Zubik et al.
7793812 September 14, 2010 Moore et al.
7794475 September 14, 2010 Hess et al.
7798386 September 21, 2010 Schall et al.
7799039 September 21, 2010 Shelton, IV et al.
7799044 September 21, 2010 Johnston et al.
7799965 September 21, 2010 Patel et al.
7803151 September 28, 2010 Whitman
7806891 October 5, 2010 Nowlin et al.
7810690 October 12, 2010 Bilotti et al.
7810691 October 12, 2010 Boyden et al.
7810692 October 12, 2010 Hall et al.
7810693 October 12, 2010 Broehl et al.
7815092 October 19, 2010 Whitman et al.
7815565 October 19, 2010 Stefanchik et al.
7819296 October 26, 2010 Hueil et al.
7819297 October 26, 2010 Doll et al.
7819298 October 26, 2010 Hall et al.
7819299 October 26, 2010 Shelton, IV et al.
7819884 October 26, 2010 Lee et al.
7819886 October 26, 2010 Whitfield et al.
7823592 November 2, 2010 Bettuchi et al.
7823760 November 2, 2010 Zemlok et al.
7824401 November 2, 2010 Manzo et al.
7824426 November 2, 2010 Racenet et al.
7828189 November 9, 2010 Holsten et al.
7828794 November 9, 2010 Sartor
7828808 November 9, 2010 Hinman et al.
7831292 November 9, 2010 Quaid et al.
7832408 November 16, 2010 Shelton, IV et al.
7832611 November 16, 2010 Boyden et al.
7832612 November 16, 2010 Baxter, III et al.
7833234 November 16, 2010 Bailly et al.
7836400 November 16, 2010 May et al.
7837079 November 23, 2010 Holsten et al.
7837080 November 23, 2010 Schwemberger
7837081 November 23, 2010 Holsten et al.
7837694 November 23, 2010 Tethrake et al.
7838789 November 23, 2010 Stoffers et al.
7841503 November 30, 2010 Sonnenschein et al.
7842025 November 30, 2010 Coleman et al.
7842028 November 30, 2010 Lee
7845533 December 7, 2010 Marczyk et al.
7845534 December 7, 2010 Viola et al.
7845535 December 7, 2010 Scircia
7845536 December 7, 2010 Viola et al.
7845537 December 7, 2010 Shelton, IV et al.
7846149 December 7, 2010 Jankowski
7850642 December 14, 2010 Moll et al.
7850982 December 14, 2010 Stopek et al.
7854736 December 21, 2010 Ryan
7857183 December 28, 2010 Shelton, IV
7857185 December 28, 2010 Swayze et al.
7857186 December 28, 2010 Baxter, III et al.
7857813 December 28, 2010 Schmitz et al.
7861906 January 4, 2011 Doll et al.
7862579 January 4, 2011 Ortiz et al.
7866525 January 11, 2011 Scirica
7866527 January 11, 2011 Hall et al.
7866528 January 11, 2011 Olson et al.
7870989 January 18, 2011 Viola et al.
7871418 January 18, 2011 Thompson et al.
7879070 February 1, 2011 Ortiz et al.
7883465 February 8, 2011 Donofrio et al.
7886951 February 15, 2011 Hessler
7886952 February 15, 2011 Scirica et al.
7887530 February 15, 2011 Zemlok et al.
7887535 February 15, 2011 Lands et al.
7891531 February 22, 2011 Ward
7891532 February 22, 2011 Mastri et al.
7892245 February 22, 2011 Liddicoat et al.
7893586 February 22, 2011 West et al.
7896214 March 1, 2011 Farascioni
7896215 March 1, 2011 Adams et al.
7896877 March 1, 2011 Hall et al.
7896895 March 1, 2011 Boudreaux et al.
7900805 March 8, 2011 Shelton, IV et al.
7905380 March 15, 2011 Shelton, IV et al.
7905381 March 15, 2011 Baxter, III et al.
7905889 March 15, 2011 Catanese, III et al.
7905902 March 15, 2011 Huitema et al.
7909191 March 22, 2011 Baker et al.
7909220 March 22, 2011 Viola
7909221 March 22, 2011 Viola et al.
7913891 March 29, 2011 Doll et al.
7913893 March 29, 2011 Mastri et al.
7914543 March 29, 2011 Roth et al.
7914551 March 29, 2011 Ortiz et al.
7918230 April 5, 2011 Whitman et al.
7918376 April 5, 2011 Knodel et al.
7918377 April 5, 2011 Measamer et al.
7918848 April 5, 2011 Lau et al.
7918867 April 5, 2011 Dana et al.
7922061 April 12, 2011 Shelton, IV et al.
7922063 April 12, 2011 Zemlok et al.
7922743 April 12, 2011 Heinrich et al.
7923144 April 12, 2011 Kohn et al.
7926691 April 19, 2011 Viola et al.
7927328 April 19, 2011 Orszulak et al.
7928281 April 19, 2011 Augustine
7930065 April 19, 2011 Larkin et al.
7931660 April 26, 2011 Aranyi et al.
7931695 April 26, 2011 Ringeisen
7934630 May 3, 2011 Shelton, IV et al.
7934631 May 3, 2011 Balbierz et al.
7935773 May 3, 2011 Hadba et al.
7938307 May 10, 2011 Bettuchi
7941865 May 10, 2011 Seman, Jr. et al.
7942303 May 17, 2011 Shah
7942890 May 17, 2011 D'Agostino et al.
7944175 May 17, 2011 Mori et al.
7945792 May 17, 2011 Cherpantier
7950560 May 31, 2011 Zemlok et al.
7950561 May 31, 2011 Aranyi
7951071 May 31, 2011 Whitman et al.
7951166 May 31, 2011 Orban et al.
7954682 June 7, 2011 Giordano et al.
7954684 June 7, 2011 Boudreaux
7954686 June 7, 2011 Baxter, III et al.
7954687 June 7, 2011 Zemlok et al.
7955257 June 7, 2011 Frasier et al.
7955322 June 7, 2011 Devengenzo et al.
7955380 June 7, 2011 Chu et al.
7959050 June 14, 2011 Smith et al.
7959051 June 14, 2011 Smith et al.
7959052 June 14, 2011 Sonnenschein et al.
7963432 June 21, 2011 Knodel et al.
7963433 June 21, 2011 Whitman et al.
7963963 June 21, 2011 Francischelli et al.
7963964 June 21, 2011 Santilli et al.
7964206 June 21, 2011 Suokas et al.
7966799 June 28, 2011 Morgan et al.
7967178 June 28, 2011 Scirica et al.
7967179 June 28, 2011 Olson et al.
7967180 June 28, 2011 Scirica
7967181 June 28, 2011 Viola et al.
7967839 June 28, 2011 Flock et al.
7972298 July 5, 2011 Wallace et al.
7980443 July 19, 2011 Scheib et al.
7987405 July 26, 2011 Turner et al.
7988026 August 2, 2011 Knodel et al.
7988027 August 2, 2011 Olson et al.
7988028 August 2, 2011 Farascioni et al.
7992757 August 9, 2011 Wheeler et al.
7993360 August 9, 2011 Hacker et al.
7994670 August 9, 2011 Ji
7997468 August 16, 2011 Farascioni
7997469 August 16, 2011 Olson et al.
8002696 August 23, 2011 Suzuki
8002784 August 23, 2011 Jinno et al.
8002785 August 23, 2011 Weiss et al.
8002795 August 23, 2011 Beetel
8006365 August 30, 2011 Levin et al.
8006885 August 30, 2011 Marczyk
8006889 August 30, 2011 Adams et al.
8007511 August 30, 2011 Brock et al.
8011550 September 6, 2011 Aranyi et al.
8011551 September 6, 2011 Marczyk et al.
8011553 September 6, 2011 Mastri et al.
8011555 September 6, 2011 Tarinelli et al.
8012170 September 6, 2011 Whitman et al.
8016176 September 13, 2011 Kasvikis et al.
8016177 September 13, 2011 Bettuchi et al.
8016178 September 13, 2011 Olson et al.
8016855 September 13, 2011 Whitman et al.
8016858 September 13, 2011 Whitman
8016881 September 13, 2011 Furst
8020742 September 20, 2011 Marczyk
8020743 September 20, 2011 Shelton, IV
8021375 September 20, 2011 Aldrich et al.
8025199 September 27, 2011 Whitman et al.
8028883 October 4, 2011 Stopek
8028884 October 4, 2011 Sniffin et al.
8028885 October 4, 2011 Smith et al.
8034077 October 11, 2011 Smith et al.
8034363 October 11, 2011 Li et al.
8037591 October 18, 2011 Spivey et al.
8038045 October 18, 2011 Bettuchi et al.
8038046 October 18, 2011 Smith et al.
8038686 October 18, 2011 Huitema et al.
8043207 October 25, 2011 Adams
8043328 October 25, 2011 Hahnen et al.
8044536 October 25, 2011 Nguyen et al.
8047236 November 1, 2011 Perry
8048503 November 1, 2011 Farnsworth et al.
8056787 November 15, 2011 Boudreaux et al.
8056788 November 15, 2011 Mastri et al.
8057508 November 15, 2011 Shelton, IV
8058771 November 15, 2011 Giordano et al.
8060250 November 15, 2011 Reiland et al.
8061576 November 22, 2011 Cappola
8062330 November 22, 2011 Prommersberger et al.
8063619 November 22, 2011 Zhu et al.
8066167 November 29, 2011 Measamer et al.
8066168 November 29, 2011 Vidal et al.
D650074 December 6, 2011 Hunt et al.
8070033 December 6, 2011 Milliman et al.
8070035 December 6, 2011 Holsten et al.
8070743 December 6, 2011 Kagan et al.
8075571 December 13, 2011 Vitali et al.
8079950 December 20, 2011 Stern et al.
8080004 December 20, 2011 Downey et al.
8083118 December 27, 2011 Milliman et al.
8083119 December 27, 2011 Prommersberger
8083120 December 27, 2011 Shelton, IV et al.
8084001 December 27, 2011 Burns et al.
8085013 December 27, 2011 Wei et al.
8087563 January 3, 2012 Milliman et al.
8089509 January 3, 2012 Chatenever et al.
8091756 January 10, 2012 Viola
8092443 January 10, 2012 Bischoff
8092932 January 10, 2012 Phillips et al.
8096458 January 17, 2012 Hessler
8097017 January 17, 2012 Viola
8100310 January 24, 2012 Zemlok
8100872 January 24, 2012 Patel
8102278 January 24, 2012 Deck et al.
8105350 January 31, 2012 Lee et al.
8107925 January 31, 2012 Natsuno et al.
8108072 January 31, 2012 Zhao et al.
8109426 February 7, 2012 Milliman et al.
8110208 February 7, 2012 Hen
8113405 February 14, 2012 Milliman
8113410 February 14, 2012 Hall et al.
8114100 February 14, 2012 Smith et al.
8122128 February 21, 2012 Burke
8123103 February 28, 2012 Milliman
8123766 February 28, 2012 Bauman et al.
8123767 February 28, 2012 Bauman et al.
8125168 February 28, 2012 Johnson et al.
8127975 March 6, 2012 Olson et al.
8127976 March 6, 2012 Scirica et al.
8128624 March 6, 2012 Couture et al.
8128643 March 6, 2012 Aranyi et al.
8128645 March 6, 2012 Sonnenschein et al.
8132703 March 13, 2012 Milliman et al.
8132706 March 13, 2012 Marczyk et al.
8134306 March 13, 2012 Drader et al.
8136712 March 20, 2012 Zingman
8136713 March 20, 2012 Hathaway et al.
8137339 March 20, 2012 Jinno et al.
8140417 March 20, 2012 Shibata
8141762 March 27, 2012 Bedi et al.
8141763 March 27, 2012 Milliman
8142425 March 27, 2012 Eggers
8146790 April 3, 2012 Milliman
8147485 April 3, 2012 Wham et al.
8152041 April 10, 2012 Kostrzewski
8154239 April 10, 2012 Katsuki et al.
8157145 April 17, 2012 Shelton, IV et al.
8157148 April 17, 2012 Scirica
8157151 April 17, 2012 Ingmanson et al.
8157152 April 17, 2012 Holsten et al.
8157153 April 17, 2012 Shelton, IV et al.
8157793 April 17, 2012 Omori et al.
8161977 April 24, 2012 Shelton, IV et al.
8162138 April 24, 2012 Bettenhausen et al.
8162197 April 24, 2012 Mastri et al.
8167185 May 1, 2012 Shelton, IV et al.
8167895 May 1, 2012 D'Agostino et al.
8167898 May 1, 2012 Schaller et al.
8170241 May 1, 2012 Roe et al.
8172120 May 8, 2012 Boyden et al.
8172122 May 8, 2012 Kasvikis et al.
8172124 May 8, 2012 Shelton, IV et al.
8177797 May 15, 2012 Shimoji et al.
8179705 May 15, 2012 Chapuis
8180458 May 15, 2012 Kane et al.
8181840 May 22, 2012 Milliman
8186555 May 29, 2012 Shelton, IV et al.
8186560 May 29, 2012 Hess et al.
8191752 June 5, 2012 Scirica
8192460 June 5, 2012 Orban, III et al.
8196795 June 12, 2012 Moore et al.
8196796 June 12, 2012 Shelton, IV et al.
8197501 June 12, 2012 Shadeck et al.
8197502 June 12, 2012 Smith et al.
8201720 June 19, 2012 Hessler
8201721 June 19, 2012 Zemlok et al.
8205779 June 26, 2012 Ma
8205780 June 26, 2012 Sorrentino et al.
8205781 June 26, 2012 Baxter, III et al.
8210411 July 3, 2012 Yates et al.
8210414 July 3, 2012 Bettuchi et al.
8210415 July 3, 2012 Ward
8210416 July 3, 2012 Milliman et al.
8211125 July 3, 2012 Spivey
8214019 July 3, 2012 Govari et al.
8215531 July 10, 2012 Shelton, IV et al.
8215533 July 10, 2012 Viola et al.
8220468 July 17, 2012 Cooper et al.
8220688 July 17, 2012 Laurent et al.
8220690 July 17, 2012 Hess et al.
8221424 July 17, 2012 Cha
8225799 July 24, 2012 Bettuchi
8226715 July 24, 2012 Hwang et al.
8227946 July 24, 2012 Kim
8228048 July 24, 2012 Spencer
8231040 July 31, 2012 Zemlok et al.
8231041 July 31, 2012 Marczyk et al.
8231042 July 31, 2012 Hessler et al.
8231043 July 31, 2012 Tarinelli et al.
8236010 August 7, 2012 Ortiz et al.
8241271 August 14, 2012 Millman et al.
8241308 August 14, 2012 Kortenbach et al.
8241322 August 14, 2012 Whitman et al.
8245594 August 21, 2012 Rogers et al.
8245898 August 21, 2012 Smith et al.
8245899 August 21, 2012 Swensgard et al.
8245900 August 21, 2012 Scirica
8245901 August 21, 2012 Stopek
8246637 August 21, 2012 Viola et al.
8256654 September 4, 2012 Bettuchi et al.
8256655 September 4, 2012 Sniffin et al.
8256656 September 4, 2012 Milliman et al.
8257251 September 4, 2012 Shelton, IV et al.
8257356 September 4, 2012 Bleich et al.
8257391 September 4, 2012 Orban, III et al.
8262655 September 11, 2012 Ghabrial et al.
8267300 September 18, 2012 Boudreaux
8267924 September 18, 2012 Zemlok et al.
8267946 September 18, 2012 Whitfield et al.
8267951 September 18, 2012 Whayne et al.
8269121 September 18, 2012 Smith
8272553 September 25, 2012 Mastri et al.
8272554 September 25, 2012 Whitman et al.
8273404 September 25, 2012 Dave et al.
8276801 October 2, 2012 Zemlok et al.
8276802 October 2, 2012 Kostrzewski
8277473 October 2, 2012 Sunaoshi et al.
8281973 October 9, 2012 Wenchell et al.
8281974 October 9, 2012 Hessler et al.
8282654 October 9, 2012 Ferrari et al.
8286845 October 16, 2012 Perry et al.
8287561 October 16, 2012 Nunez et al.
8292147 October 23, 2012 Viola
8292150 October 23, 2012 Bryant
8292151 October 23, 2012 Viola
8292152 October 23, 2012 Milliman et al.
8292155 October 23, 2012 Shelton, IV et al.
8292157 October 23, 2012 Smith et al.
8292888 October 23, 2012 Whitman
8298161 October 30, 2012 Vargas
8298677 October 30, 2012 Wiesner et al.
8302323 November 6, 2012 Fortier et al.
8308040 November 13, 2012 Huang et al.
8308042 November 13, 2012 Aranyi
8308046 November 13, 2012 Prommersberger
8308659 November 13, 2012 Scheibe et al.
8313496 November 20, 2012 Sauer et al.
8313509 November 20, 2012 Kostrzewski
8317070 November 27, 2012 Hueil et al.
8317071 November 27, 2012 Knodel
8317074 November 27, 2012 Ortiz et al.
8317790 November 27, 2012 Bell et al.
8319002 November 27, 2012 Daniels et al.
8322455 December 4, 2012 Shelton, IV et al.
8322589 December 4, 2012 Boudreaux
8322590 December 4, 2012 Patel et al.
8323789 December 4, 2012 Rozhin et al.
8328061 December 11, 2012 Kasvikis
8328062 December 11, 2012 Viola
8328063 December 11, 2012 Milliman et al.
8328064 December 11, 2012 Racenet et al.
8328802 December 11, 2012 Deville et al.
8328823 December 11, 2012 Aranyi et al.
8333313 December 18, 2012 Boudreaux et al.
8333764 December 18, 2012 Francischelli et al.
8336753 December 25, 2012 Olson et al.
8336754 December 25, 2012 Cappola et al.
8342377 January 1, 2013 Milliman et al.
8342378 January 1, 2013 Marczyk et al.
8342379 January 1, 2013 Whitman et al.
8348123 January 8, 2013 Scirica et al.
8348125 January 8, 2013 Viola et al.
8348126 January 8, 2013 Olson et al.
8348127 January 8, 2013 Marczyk
8348129 January 8, 2013 Bedi et al.
8348130 January 8, 2013 Shah et al.
8348131 January 8, 2013 Omaits et al.
8348972 January 8, 2013 Soltz et al.
8353437 January 15, 2013 Boudreaux
8353438 January 15, 2013 Baxter, III et al.
8353439 January 15, 2013 Baxter, III et al.
8356740 January 22, 2013 Knodel
8357144 January 22, 2013 Whitman et al.
8360296 January 29, 2013 Zingman
8360297 January 29, 2013 Shelton, IV et al.
8360298 January 29, 2013 Farascioni et al.
8360299 January 29, 2013 Zemlok et al.
8361501 January 29, 2013 DiTizio et al.
8365973 February 5, 2013 White et al.
8365975 February 5, 2013 Manoux et al.
8365976 February 5, 2013 Hess et al.
8366559 February 5, 2013 Papenfuss et al.
8371491 February 12, 2013 Huitema et al.
8371492 February 12, 2013 Aranyi et al.
8371493 February 12, 2013 Aranyi et al.
8372094 February 12, 2013 Bettuchi et al.
8376865 February 19, 2013 Forster et al.
8377044 February 19, 2013 Coe et al.
8388633 March 5, 2013 Rousseau et al.
8389588 March 5, 2013 Ringelsen
8393513 March 12, 2013 Jankowski
8393514 March 12, 2013 Shelton, IV et al.
8393516 March 12, 2013 Kostrzewski
8397971 March 19, 2013 Yates et al.
8398633 March 19, 2013 Mueller
8398673 March 19, 2013 Hinchliffe et al.
8403138 March 26, 2013 Weisshaupt et al.
8403198 March 26, 2013 Sorrentino et al.
8403832 March 26, 2013 Cunningham et al.
8403945 March 26, 2013 Whitfield et al.
8408439 April 2, 2013 Huang et al.
8408442 April 2, 2013 Racenet et al.
8409079 April 2, 2013 Oakamoto et al.
8409174 April 2, 2013 Omori
8409222 April 2, 2013 Whitfield et al.
8409223 April 2, 2013 Sorrentino et al.
8413870 April 9, 2013 Pastorelli et al.
8413871 April 9, 2013 Racenet et al.
8413872 April 9, 2013 Patel
8414577 April 9, 2013 Boudreaux et al.
8418909 April 16, 2013 Kostrzewski
8424737 April 23, 2013 Scirica
8424739 April 23, 2013 Racenet et al.
8424740 April 23, 2013 Shelton, IV et al.
8424741 April 23, 2013 McGuckin, Jr. et al.
8425600 April 23, 2013 Maxwell
8430292 April 30, 2013 Patel et al.
8430892 April 30, 2013 Bindra et al.
8430898 April 30, 2013 Wiener et al.
8435257 May 7, 2013 Smith et al.
8439246 May 14, 2013 Knodel et al.
8444036 May 21, 2013 Shelton, IV
8444549 May 21, 2013 Viola et al.
8453904 June 4, 2013 Eskaros et al.
8453906 June 4, 2013 Huang et al.
8453907 June 4, 2013 Laurent et al.
8453908 June 4, 2013 Bedi et al.
8453912 June 4, 2013 Mastri et al.
8453914 June 4, 2013 Laurent et al.
8454628 June 4, 2013 Smith et al.
8457757 June 4, 2013 Cauller et al.
8459520 June 11, 2013 Giordano et al.
8459525 June 11, 2013 Yates et al.
8464922 June 18, 2013 Marczyk
8464923 June 18, 2013 Shelton, IV
8464924 June 18, 2013 Gresham et al.
8464925 June 18, 2013 Hull et al.
8465502 June 18, 2013 Zergiebel
8469973 June 25, 2013 Meade et al.
8474677 July 2, 2013 Woodard, Jr. et al.
8475453 July 2, 2013 Marczyk et al.
8475474 July 2, 2013 Bombard et al.
8479969 July 9, 2013 Shelton, IV
8480703 July 9, 2013 Nicholas et al.
8485412 July 16, 2013 Shelton, IV et al.
8485413 July 16, 2013 Scheib et al.
8490853 July 23, 2013 Criscuolo et al.
8491581 July 23, 2013 Deville et al.
8496156 July 30, 2013 Sniffin et al.
8496683 July 30, 2013 Prommersberger et al.
8499992 August 6, 2013 Whitman et al.
8499993 August 6, 2013 Shelton, IV et al.
8500762 August 6, 2013 Sholev et al.
8506557 August 13, 2013 Zemlok et al.
8506580 August 13, 2013 Zergiebel et al.
8506581 August 13, 2013 Wingardner, III et al.
8511308 August 20, 2013 Hecox et al.
8512359 August 20, 2013 Whitman et al.
8517239 August 27, 2013 Scheib et al.
8517241 August 27, 2013 Nicholas et al.
8517243 August 27, 2013 Giordano et al.
8517244 August 27, 2013 Shelton, IV et al.
8521273 August 27, 2013 Kliman
8523043 September 3, 2013 Ullrich et al.
8523881 September 3, 2013 Cabiri et al.
8523900 September 3, 2013 Jinno et al.
8529588 September 10, 2013 Ahlberg et al.
8529600 September 10, 2013 Woodard, Jr. et al.
8529819 September 10, 2013 Ostapoff et al.
8534528 September 17, 2013 Shelton, IV
8535304 September 17, 2013 Sklar et al.
8540128 September 24, 2013 Shelton, IV et al.
8540129 September 24, 2013 Baxter, III et al.
8540130 September 24, 2013 Moore et al.
8540131 September 24, 2013 Swayze
8540133 September 24, 2013 Bedi et al.
8540733 September 24, 2013 Whitman et al.
8540735 September 24, 2013 Mitelberg et al.
8551076 October 8, 2013 Duval et al.
8556151 October 15, 2013 Viola
8556918 October 15, 2013 Bauman et al.
8561870 October 22, 2013 Baxter, III et al.
8561873 October 22, 2013 Ingmanson et al.
8567656 October 29, 2013 Shelton, IV et al.
8573461 November 5, 2013 Shelton, IV et al.
8573465 November 5, 2013 Shelton, IV et al.
8574199 November 5, 2013 von Bülow et al.
8574263 November 5, 2013 Mueller
8575880 November 5, 2013 Grantz
8579176 November 12, 2013 Smith et al.
8579178 November 12, 2013 Holsten et al.
8579897 November 12, 2013 Vakharia et al.
8579937 November 12, 2013 Gresham
8584919 November 19, 2013 Hueil et al.
8585721 November 19, 2013 Kirsch
8590762 November 26, 2013 Hess et al.
8602287 December 10, 2013 Yates et al.
8602288 December 10, 2013 Shelton, IV et al.
8603135 December 10, 2013 Mueller
8608044 December 17, 2013 Hueil et al.
8608045 December 17, 2013 Smith et al.
8608046 December 17, 2013 Laurent et al.
8608745 December 17, 2013 Guzman et al.
8613383 December 24, 2013 Beckman et al.
8616431 December 31, 2013 Timm et al.
8622274 January 7, 2014 Yates et al.
8622275 January 7, 2014 Baxter, III et al.
8628518 January 14, 2014 Blumenkranz et al.
8628545 January 14, 2014 Cabrera et al.
8631987 January 21, 2014 Shelton, IV et al.
8632462 January 21, 2014 Yoo et al.
8632525 January 21, 2014 Kerr et al.
8632535 January 21, 2014 Shelton, IV et al.
8632563 January 21, 2014 Nagase et al.
8636187 January 28, 2014 Hueil et al.
8636736 January 28, 2014 Yates et al.
8636766 January 28, 2014 Milliman et al.
8640788 February 4, 2014 Dachs, II et al.
8647258 February 11, 2014 Aranyi et al.
8652120 February 18, 2014 Giordano et al.
8652151 February 18, 2014 Lehman et al.
8657174 February 25, 2014 Yates et al.
8657176 February 25, 2014 Shelton, IV et al.
8657177 February 25, 2014 Scirica et al.
8657178 February 25, 2014 Hueil et al.
8657482 February 25, 2014 Malackowski et al.
8657808 February 25, 2014 McPherson et al.
8662370 March 4, 2014 Takei
8663192 March 4, 2014 Hester et al.
8668129 March 11, 2014 Olson
8668130 March 11, 2014 Hess et al.
8672206 March 18, 2014 Aranyi et al.
8672207 March 18, 2014 Shelton, IV et al.
8672208 March 18, 2014 Hess et al.
8673210 March 18, 2014 Deshays
8678263 March 25, 2014 Viola
8679093 March 25, 2014 Farra
8679098 March 25, 2014 Hart
8679137 March 25, 2014 Bauman et al.
8679454 March 25, 2014 Guire et al.
8684250 April 1, 2014 Bettuchi et al.
8684253 April 1, 2014 Giordano et al.
8685020 April 1, 2014 Weizman et al.
8695866 April 15, 2014 Leimbach et al.
8696665 April 15, 2014 Hunt et al.
8701958 April 22, 2014 Shelton, IV et al.
8701959 April 22, 2014 Shah
8708211 April 29, 2014 Zemlok et al.
8708213 April 29, 2014 Shelton, IV et al.
8715256 May 6, 2014 Greener
8720766 May 13, 2014 Hess et al.
8721630 May 13, 2014 Ortiz et al.
8721666 May 13, 2014 Schroeder et al.
8727197 May 20, 2014 Hess et al.
8727200 May 20, 2014 Roy
8728119 May 20, 2014 Cummins
8733613 May 27, 2014 Huitema et al.
8733614 May 27, 2014 Ross et al.
8734478 May 27, 2014 Widenhouse et al.
8739033 May 27, 2014 Rosenberg
8740034 June 3, 2014 Morgan et al.
8740037 June 3, 2014 Shelton, IV et al.
8740038 June 3, 2014 Shelton, IV et al.
8740987 June 3, 2014 Geremakis et al.
8746529 June 10, 2014 Shelton, IV et al.
8746530 June 10, 2014 Giordano et al.
8746533 June 10, 2014 Whitman et al.
8746535 June 10, 2014 Shelton, IV et al.
8747238 June 10, 2014 Shelton, IV et al.
8752264 June 17, 2014 Ackley et al.
8752699 June 17, 2014 Morgan et al.
8752747 June 17, 2014 Shelton, IV et al.
8752749 June 17, 2014 Moore et al.
8757465 June 24, 2014 Woodard, Jr. et al.
8758235 June 24, 2014 Jaworek
8758391 June 24, 2014 Swayze et al.
8758438 June 24, 2014 Boyce et al.
8763875 July 1, 2014 Morgan et al.
8763877 July 1, 2014 Schall et al.
8763879 July 1, 2014 Shelton, IV et al.
8771169 July 8, 2014 Whitman et al.
8777004 July 15, 2014 Shelton, IV et al.
8783541 July 22, 2014 Shelton, IV et al.
8783542 July 22, 2014 Riestenberg et al.
8783543 July 22, 2014 Shelton, IV et al.
8784404 July 22, 2014 Doyle et al.
8784415 July 22, 2014 Malackowski et al.
8789737 July 29, 2014 Hodgkinson et al.
8789739 July 29, 2014 Swensgard
8789740 July 29, 2014 Baxter, III et al.
8789741 July 29, 2014 Baxter, III et al.
8790684 July 29, 2014 Dave et al.
8794496 August 5, 2014 Scirica
8794497 August 5, 2014 Zingman
8795276 August 5, 2014 Dietz et al.
8800838 August 12, 2014 Shelton, IV
8800839 August 12, 2014 Beetel
8800841 August 12, 2014 Ellerhorst et al.
8801734 August 12, 2014 Shelton, IV et al.
8801735 August 12, 2014 Shelton, IV et al.
8801752 August 12, 2014 Fortier et al.
8806973 August 19, 2014 Ross et al.
8807414 August 19, 2014 Ross et al.
8808294 August 19, 2014 Fox et al.
8808308 August 19, 2014 Boukhny et al.
8808311 August 19, 2014 Heinrich et al.
8813866 August 26, 2014 Suzuki
8814024 August 26, 2014 Woodard, Jr. et al.
8814025 August 26, 2014 Miller et al.
8820603 September 2, 2014 Shelton, IV et al.
8820605 September 2, 2014 Shelton, IV
8820606 September 2, 2014 Hodgkinson
8820607 September 2, 2014 Marczyk
8822934 September 2, 2014 Sayeh et al.
8827133 September 9, 2014 Shelton, IV et al.
8827903 September 9, 2014 Shelton, IV et al.
8833632 September 16, 2014 Swensgard
8840003 September 23, 2014 Morgan et al.
8840603 September 23, 2014 Shelton, IV et al.
8844789 September 30, 2014 Shelton, IV et al.
8851354 October 7, 2014 Swensgard et al.
8852199 October 7, 2014 Deslauriers et al.
8857693 October 14, 2014 Schuckmann et al.
8857694 October 14, 2014 Shelton, IV et al.
8858571 October 14, 2014 Shelton, IV et al.
8858590 October 14, 2014 Shelton, IV et al.
8864007 October 21, 2014 Widenhouse et al.
8864009 October 21, 2014 Shelton, IV et al.
8870050 October 28, 2014 Hodgkinson
8875971 November 4, 2014 Hall et al.
8875972 November 4, 2014 Weisenburgh, II et al.
8876857 November 4, 2014 Burbank
8888688 November 18, 2014 Julian et al.
8893946 November 25, 2014 Boudreaux et al.
8893949 November 25, 2014 Shelton, IV et al.
8894647 November 25, 2014 Beardsley et al.
8894654 November 25, 2014 Anderson
8899463 December 2, 2014 Schall et al.
8899464 December 2, 2014 Hueil et al.
8899465 December 2, 2014 Shelton, IV et al.
8899466 December 2, 2014 Baxter, III et al.
8905977 December 9, 2014 Shelton et al.
8911426 December 16, 2014 Coppeta et al.
8911471 December 16, 2014 Spivey et al.
8920438 December 30, 2014 Aranyi et al.
8925782 January 6, 2015 Shelton, IV
8925783 January 6, 2015 Zemlok et al.
8925788 January 6, 2015 Hess et al.
8926598 January 6, 2015 Mollere et al.
8931682 January 13, 2015 Timm et al.
8936614 January 20, 2015 Allen, IV
8939343 January 27, 2015 Milliman et al.
8939344 January 27, 2015 Olson et al.
8955732 February 17, 2015 Zemlok et al.
8956342 February 17, 2015 Russo et al.
8960520 February 24, 2015 McCuen
8960521 February 24, 2015 Kostrzewski
8961504 February 24, 2015 Hoarau et al.
8967443 March 3, 2015 McCuen
8967446 March 3, 2015 Beardsley et al.
8968276 March 3, 2015 Zemlok et al.
8968312 March 3, 2015 Marczyk et al.
8968337 March 3, 2015 Whitfield et al.
8968340 March 3, 2015 Chowaniec et al.
8970507 March 3, 2015 Holbein et al.
8973803 March 10, 2015 Hall et al.
8973804 March 10, 2015 Hess et al.
8978954 March 17, 2015 Shelton, IV et al.
8978955 March 17, 2015 Aronhalt et al.
8978956 March 17, 2015 Schall et al.
8979890 March 17, 2015 Boudreaux
8982195 March 17, 2015 Claus et al.
8991676 March 31, 2015 Hess et al.
8991677 March 31, 2015 Moore et al.
8992422 March 31, 2015 Spivey et al.
8992565 March 31, 2015 Brisson et al.
8996165 March 31, 2015 Wang et al.
8998058 April 7, 2015 Moore et al.
9005230 April 14, 2015 Yates et al.
9011471 April 21, 2015 Timm et al.
9016539 April 28, 2015 Kostrzewski et al.
9016540 April 28, 2015 Whitman et al.
9016542 April 28, 2015 Shelton, IV et al.
9017331 April 28, 2015 Fox
9017371 April 28, 2015 Whitman et al.
9023014 May 5, 2015 Chowaniec et al.
9027817 May 12, 2015 Milliman et al.
9028494 May 12, 2015 Shelton, IV et al.
9028495 May 12, 2015 Mueller et al.
9028519 May 12, 2015 Yates et al.
9033203 May 19, 2015 Woodard, Jr. et al.
9033204 May 19, 2015 Shelton, IV et al.
9038881 May 26, 2015 Schaller et al.
9039690 May 26, 2015 Kersten et al.
9039720 May 26, 2015 Madan
9043027 May 26, 2015 Durant et al.
9044227 June 2, 2015 Shelton, IV et al.
9044228 June 2, 2015 Woodard, Jr. et al.
9044230 June 2, 2015 Morgan et al.
9050083 June 9, 2015 Yates et al.
9050084 June 9, 2015 Schmid et al.
9050100 June 9, 2015 Yates et al.
9055941 June 16, 2015 Schmid et al.
9055944 June 16, 2015 Hodgkinson et al.
9055961 June 16, 2015 Manzo et al.
9060770 June 23, 2015 Shelton, IV et al.
9072515 July 7, 2015 Hall et al.
9072535 July 7, 2015 Shelton, IV et al.
9072536 July 7, 2015 Shelton, IV et al.
9078653 July 14, 2015 Leimbach et al.
9084601 July 21, 2015 Moore et al.
9084602 July 21, 2015 Glieman
9086875 July 21, 2015 Harrat et al.
9089330 July 28, 2015 Widenhouse et al.
9095339 August 4, 2015 Moore et al.
9095362 August 4, 2015 Dachs, II et al.
9096033 August 4, 2015 Holop et al.
9099863 August 4, 2015 Smith et al.
9101358 August 11, 2015 Kerr et al.
9101385 August 11, 2015 Shelton, IV et al.
9107663 August 18, 2015 Swensgard
9113862 August 25, 2015 Morgan et al.
9113864 August 25, 2015 Morgan et al.
9113865 August 25, 2015 Shelton, IV et al.
9113873 August 25, 2015 Marczyk et al.
9113874 August 25, 2015 Shelton, IV et al.
9113880 August 25, 2015 Zemlok et al.
9113883 August 25, 2015 Aronhalt et al.
9113884 August 25, 2015 Shelton, IV et al.
9119657 September 1, 2015 Shelton, IV et al.
9123286 September 1, 2015 Park
9125654 September 8, 2015 Aronhalt et al.
9125662 September 8, 2015 Shelton, IV
9126317 September 8, 2015 Lawton et al.
9131940 September 15, 2015 Huitema et al.
9131957 September 15, 2015 Sharbnik et al.
9138225 September 22, 2015 Huang et al.
9149274 October 6, 2015 Spivey et al.
9149324 October 6, 2015 Huang et al.
9149325 October 6, 2015 Worrell et al.
9161753 October 20, 2015 Prior
9161803 October 20, 2015 Yates et al.
9168038 October 27, 2015 Shelton, IV et al.
9168054 October 27, 2015 Turner et al.
9168144 October 27, 2015 Rivin et al.
9179911 November 10, 2015 Morgan et al.
9179912 November 10, 2015 Yates et al.
9186143 November 17, 2015 Timm et al.
9186148 November 17, 2015 Felder et al.
9192380 November 24, 2015 Racenet et al.
9192384 November 24, 2015 Bettuchi
9193045 November 24, 2015 Saur et al.
9198661 December 1, 2015 Swensgard
9198662 December 1, 2015 Barton et al.
9204877 December 8, 2015 Whitman et al.
9204878 December 8, 2015 Hall et al.
9204879 December 8, 2015 Shelton, IV
9204880 December 8, 2015 Baxter, III et al.
9211120 December 15, 2015 Scheib et al.
9211121 December 15, 2015 Hall et al.
9211122 December 15, 2015 Hagerty et al.
9216019 December 22, 2015 Schmid et al.
9216020 December 22, 2015 Zhang et al.
9220500 December 29, 2015 Swayze et al.
9220501 December 29, 2015 Baxter, III et al.
9226750 January 5, 2016 Weir et al.
9226751 January 5, 2016 Shelton, IV et al.
9226767 January 5, 2016 Stulen et al.
9232941 January 12, 2016 Mandakolathur Vasudevan et al.
9232945 January 12, 2016 Zingman
9232979 January 12, 2016 Parihar et al.
9237891 January 19, 2016 Shelton, IV
9241714 January 26, 2016 Timm et al.
9259274 February 16, 2016 Prisco
9271799 March 1, 2016 Shelton, IV et al.
9272406 March 1, 2016 Aronhalt et al.
9277919 March 8, 2016 Timmer et al.
9277922 March 8, 2016 Carter et al.
9282962 March 15, 2016 Schmid et al.
9282966 March 15, 2016 Shelton, IV et al.
9282974 March 15, 2016 Shelton, IV
9283045 March 15, 2016 Rhee et al.
9283054 March 15, 2016 Morgan et al.
9289206 March 22, 2016 Hess et al.
9289207 March 22, 2016 Shelton, IV
9289210 March 22, 2016 Baxter, III et al.
9289212 March 22, 2016 Shelton, IV et al.
9289225 March 22, 2016 Shelton, IV et al.
9289256 March 22, 2016 Shelton, IV et al.
9293757 March 22, 2016 Chellew
9295464 March 29, 2016 Shelton, IV et al.
9301752 April 5, 2016 Mandakolathur Vasudevan et al.
9301753 April 5, 2016 Aldridge et al.
9301755 April 5, 2016 Shelton, IV et al.
9301759 April 5, 2016 Spivey et al.
9307965 April 12, 2016 Ming et al.
9307986 April 12, 2016 Hall et al.
9307988 April 12, 2016 Shelton, IV
9308011 April 12, 2016 Chao et al.
9314246 April 19, 2016 Shelton, IV et al.
9320518 April 26, 2016 Henderson et al.
9320520 April 26, 2016 Shelton, IV et al.
9320521 April 26, 2016 Shelton, IV et al.
9320523 April 26, 2016 Shelton, IV et al.
9326767 May 3, 2016 Koch, Jr. et al.
9326768 May 3, 2016 Shelton, IV
9326769 May 3, 2016 Shelton, IV et al.
9326770 May 3, 2016 Shelton, IV et al.
9326771 May 3, 2016 Baxter, III et al.
9332890 May 10, 2016 Ozawa
9332974 May 10, 2016 Henderson et al.
9332984 May 10, 2016 Weaner et al.
9332987 May 10, 2016 Leimbach et al.
9345477 May 24, 2016 Anim et al.
9345481 May 24, 2016 Hall et al.
9351726 May 31, 2016 Leimbach et al.
9351727 May 31, 2016 Leimbach et al.
9351730 May 31, 2016 Schmid et al.
9358003 June 7, 2016 Hall et al.
9358005 June 7, 2016 Shelton, IV et al.
9364220 June 14, 2016 Williams
9364230 June 14, 2016 Shelton, IV et al.
9364233 June 14, 2016 Alexander, III et al.
9364279 June 14, 2016 Houser et al.
9370358 June 21, 2016 Shelton, IV et al.
9370364 June 21, 2016 Smith et al.
9375206 June 28, 2016 Vidal et al.
9386983 July 12, 2016 Swensgard et al.
9386984 July 12, 2016 Aronhalt et al.
9386988 July 12, 2016 Baxter, III et al.
9393015 July 19, 2016 Laurent et al.
9398911 July 26, 2016 Auld
9402626 August 2, 2016 Ortiz et al.
9408604 August 9, 2016 Shelton, IV et al.
9408606 August 9, 2016 Shelton, IV
9414838 August 16, 2016 Shelton, IV et al.
9414849 August 16, 2016 Nagashimada
9433419 September 6, 2016 Gonzalez et al.
9445813 September 20, 2016 Shelton, IV et al.
9451958 September 27, 2016 Shelton, IV et al.
9468438 October 18, 2016 Baber et al.
9468447 October 18, 2016 Aman et al.
9480476 November 1, 2016 Aldridge et al.
9526564 December 27, 2016 Rusin
9554794 January 31, 2017 Baber et al.
9597104 March 21, 2017 Nicholas et al.
9597143 March 21, 2017 Madan et al.
9629623 April 25, 2017 Lytle, IV et al.
9629629 April 25, 2017 Leimbach et al.
9687230 June 27, 2017 Leimbach et al.
9693777 July 4, 2017 Schellin et al.
9700309 July 11, 2017 Jaworek et al.
9724094 August 8, 2017 Baber et al.
9737301 August 22, 2017 Baber et al.
9743927 August 29, 2017 Whitman
9757124 September 12, 2017 Schellin et al.
9757128 September 12, 2017 Baber et al.
9770245 September 26, 2017 Swayze et al.
9775608 October 3, 2017 Aronhalt et al.
9775610 October 3, 2017 Nicholas et al.
9782169 October 10, 2017 Swayze et al.
9788836 October 17, 2017 Overmyer et al.
9808244 November 7, 2017 Leimbach et al.
9839422 December 12, 2017 Schellin et al.
9839423 December 12, 2017 Vendely et al.
9844374 December 19, 2017 Lytle, IV et al.
9844375 December 19, 2017 Overmyer et al.
9872683 January 23, 2018 Hopkins et al.
20010025183 September 27, 2001 Shahidi
20010044637 November 22, 2001 Jacobs et al.
20020014510 February 7, 2002 Richter et al.
20020022836 February 21, 2002 Goble et al.
20020026126 February 28, 2002 Burdorff et al.
20020029032 March 7, 2002 Arkin
20020029036 March 7, 2002 Goble et al.
20020049472 April 25, 2002 Coleman et al.
20020095175 July 18, 2002 Brock et al.
20020103494 August 1, 2002 Pacey
20020117534 August 29, 2002 Green et al.
20020127265 September 12, 2002 Bowman et al.
20020128552 September 12, 2002 Nowlin et al.
20020134811 September 26, 2002 Napier et al.
20020135474 September 26, 2002 Sylliassen
20020143340 October 3, 2002 Kaneko
20020157481 October 31, 2002 Kogiso et al.
20020165541 November 7, 2002 Whitman
20020188170 December 12, 2002 Santamore et al.
20020193808 December 19, 2002 Belef et al.
20030023316 January 30, 2003 Brown et al.
20030066858 April 10, 2003 Holgersson
20030078647 April 24, 2003 Vallana et al.
20030084983 May 8, 2003 Rangachari et al.
20030093103 May 15, 2003 Malackowski et al.
20030096158 May 22, 2003 Takano et al.
20030105478 June 5, 2003 Whitman et al.
20030114851 June 19, 2003 Truckai et al.
20030130677 July 10, 2003 Whitman et al.
20030139741 July 24, 2003 Goble et al.
20030153908 August 14, 2003 Goble et al.
20030153968 August 14, 2003 Geis et al.
20030163085 August 28, 2003 Tanner et al.
20030181900 September 25, 2003 Long
20030195387 October 16, 2003 Kortenbach et al.
20030202901 October 30, 2003 Stetzel
20030205029 November 6, 2003 Chapolini et al.
20030216732 November 20, 2003 Truckai et al.
20030220660 November 27, 2003 Kortenbach et al.
20030236505 December 25, 2003 Bonadio et al.
20040002726 January 1, 2004 Nunez et al.
20040006335 January 8, 2004 Garrison
20040006340 January 8, 2004 Latterell et al.
20040006372 January 8, 2004 Racenet et al.
20040006861 January 15, 2004 Haytayan
20040030333 February 12, 2004 Goble
20040032345 February 19, 2004 Kazuya et al.
20040034357 February 19, 2004 Beane et al.
20040034369 February 19, 2004 Sauer et al.
20040044364 March 4, 2004 DeVries et al.
20040068161 April 8, 2004 Couvillon, Jr.
20040068224 April 8, 2004 Couvillon, Jr. et al.
20040068307 April 8, 2004 Goble
20040070369 April 15, 2004 Sakahibara
20040073222 April 15, 2004 Koseki
20040078037 April 22, 2004 Batchelor et al.
20040093024 May 13, 2004 Lousararian et al.
20040094597 May 20, 2004 Whitman et al.
20040097987 May 20, 2004 Pugsley et al.
20040098040 May 20, 2004 Taniguchi et al.
20040101822 May 27, 2004 Weisner et al.
20040102783 May 27, 2004 Sutterlin, III et al.
20040108357 June 10, 2004 Milliman et al.
20040110439 June 10, 2004 Chaikof et al.
20040111081 June 10, 2004 Whitman et al.
20040115022 June 17, 2004 Albertson et al.
20040116952 June 17, 2004 Sakurai et al.
20040133095 July 8, 2004 Dunki-Jacobs et al.
20040143297 July 22, 2004 Ramsey
20040147909 July 29, 2004 Johnston et al.
20040164123 August 26, 2004 Racenet et al.
20040167572 August 26, 2004 Roth et al.
20040173659 September 9, 2004 Green et al.
20040181219 September 16, 2004 Goble et al.
20040186470 September 23, 2004 Goble et al.
20040193189 September 30, 2004 Kortenbach et al.
20040199181 October 7, 2004 Knodel et al.
20040222268 November 11, 2004 Bilotti et al.
20040225186 November 11, 2004 Home, Jr. et al.
20040230214 November 18, 2004 Donofrio et al.
20040232201 November 25, 2004 Wenchell et al.
20040236352 November 25, 2004 Wang et al.
20040243147 December 2, 2004 Lipow
20040243151 December 2, 2004 Demmy et al.
20040243163 December 2, 2004 Casiano et al.
20040243176 December 2, 2004 Hahnen et al.
20040247415 December 9, 2004 Mangone, Jr.
20040254455 December 16, 2004 Iddan
20040254566 December 16, 2004 Plicchi et al.
20040254590 December 16, 2004 Hoffman et al.
20040254608 December 16, 2004 Huitema et al.
20040260315 December 23, 2004 Dell et al.
20040267297 December 30, 2004 Malackowski
20040267310 December 30, 2004 Racenet et al.
20050010158 January 13, 2005 Brugger et al.
20050010213 January 13, 2005 Stad et al.
20050032511 February 10, 2005 Malone et al.
20050033352 February 10, 2005 Zeph et al.
20050033357 February 10, 2005 Braun
20050054946 March 10, 2005 Krzyzanowski
20050058890 March 17, 2005 Brazell et al.
20050059997 March 17, 2005 Bauman et al.
20050070929 March 31, 2005 Dalessandro et al.
20050075561 April 7, 2005 Golden
20050080454 April 14, 2005 Drews et al.
20050085693 April 21, 2005 Belson et al.
20050090817 April 28, 2005 Phan
20050096683 May 5, 2005 Ellins et al.
20050103819 May 19, 2005 Racenet et al.
20050107814 May 19, 2005 Johnston et al.
20050107824 May 19, 2005 Hillstead et al.
20050113820 May 26, 2005 Goble et al.
20050116673 June 2, 2005 Carl et al.
20050119525 June 2, 2005 Takemoto
20050119669 June 2, 2005 Demmy
20050124855 June 9, 2005 Jaffe et al.
20050125009 June 9, 2005 Perry et al.
20050125897 June 16, 2005 Wyslucha et al.
20050131173 June 16, 2005 McDaniel et al.
20050131211 June 16, 2005 Bayley et al.
20050131390 June 16, 2005 Heinrich et al.
20050131436 June 16, 2005 Johnston et al.
20050131437 June 16, 2005 Johnston et al.
20050131457 June 16, 2005 Douglas et al.
20050137454 June 23, 2005 Saadat et al.
20050137455 June 23, 2005 Ewers et al.
20050143759 June 30, 2005 Kelly
20050143769 June 30, 2005 White et al.
20050145675 July 7, 2005 Hartwick et al.
20050150928 July 14, 2005 Kameyama et al.
20050154258 July 14, 2005 Tartaglia et al.
20050154406 July 14, 2005 Bombard et al.
20050159184 July 21, 2005 Kerner et al.
20050165419 July 28, 2005 Sauer et al.
20050165435 July 28, 2005 Johnston et al.
20050169974 August 4, 2005 Tenerz et al.
20050171522 August 4, 2005 Christopherson
20050177181 August 11, 2005 Kagan et al.
20050182298 August 18, 2005 Ikeda et al.
20050187545 August 25, 2005 Hooven et al.
20050187572 August 25, 2005 Johnston et al.
20050187576 August 25, 2005 Whitman et al.
20050189397 September 1, 2005 Jankowski
20050192609 September 1, 2005 Whitman et al.
20050192628 September 1, 2005 Viola
20050203550 September 15, 2005 Laufer et al.
20050216055 September 29, 2005 Scirica et al.
20050228224 October 13, 2005 Okada et al.
20050240178 October 27, 2005 Morley et al.
20050240222 October 27, 2005 Shipp
20050245965 November 3, 2005 Orban, III et al.
20050251128 November 10, 2005 Amoah
20050256452 November 17, 2005 DeMarchi et al.
20050256522 November 17, 2005 Francischelli et al.
20050261676 November 24, 2005 Hall et al.
20050261677 November 24, 2005 Hall et al.
20050263563 December 1, 2005 Racenet et al.
20050267455 December 1, 2005 Eggers et al.
20050267530 December 1, 2005 Cummins
20050272973 December 8, 2005 Kawano et al.
20050274768 December 15, 2005 Cummins et al.
20050283188 December 22, 2005 Loshakove et al.
20060004407 January 5, 2006 Hiles et al.
20060008787 January 12, 2006 Hayman et al.
20060011699 January 19, 2006 Olson et al.
20060015009 January 19, 2006 Jaffe et al.
20060020247 January 26, 2006 Kagan et al.
20060020258 January 26, 2006 Strauss et al.
20060020336 January 26, 2006 Liddicoat
20060025811 February 2, 2006 Shelton, IV
20060025812 February 2, 2006 Shelton, IV
20060025816 February 2, 2006 Shelton, IV
20060041188 February 23, 2006 Dirusso et al.
20060047275 March 2, 2006 Goble
20060047303 March 2, 2006 Ortiz et al.
20060047307 March 2, 2006 Ortiz et al.
20060049229 March 9, 2006 Milliman et al.
20060052825 March 9, 2006 Ransick et al.
20060060630 March 23, 2006 Shelton, IV et al.
20060064086 March 23, 2006 Odom
20060079115 April 13, 2006 Aranyi et al.
20060079735 April 13, 2006 Martone et al.
20060085031 April 20, 2006 Bettuchi
20060085033 April 20, 2006 Criscuolo et al.
20060086032 April 27, 2006 Valencic et al.
20060087746 April 27, 2006 Lipow
20060089535 April 27, 2006 Raz et al.
20060100643 May 11, 2006 Laufer et al.
20060100649 May 11, 2006 Hart
20060108393 May 25, 2006 Heinrich et al.
20060111711 May 25, 2006 Goble
20060111723 May 25, 2006 Chapolini et al.
20060116634 June 1, 2006 Shachar
20060122636 June 8, 2006 Bailly et al.
20060142772 June 29, 2006 Ralph et al.
20060149163 July 6, 2006 Hibner et al.
20060161185 July 20, 2006 Saadat et al.
20060167471 July 27, 2006 Phillips
20060173470 August 3, 2006 Oray et al.
20060178556 August 10, 2006 Hasser et al.
20060180634 August 17, 2006 Shelton, IV et al.
20060185682 August 24, 2006 Marczyk
20060200123 September 7, 2006 Ryan
20060201989 September 14, 2006 Ojeda
20060206100 September 14, 2006 Eskridge et al.
20060212069 September 21, 2006 Shelton, IV
20060217729 September 28, 2006 Eskridge et al.
20060226196 October 12, 2006 Hueil et al.
20060235368 October 19, 2006 Oz
20060235469 October 19, 2006 Viola
20060241655 October 26, 2006 Viola
20060241692 October 26, 2006 McGuckin, Jr. et al.
20060244460 November 2, 2006 Weaver
20060252990 November 9, 2006 Kubach
20060252993 November 9, 2006 Freed et al.
20060253069 November 9, 2006 Li et al.
20060258904 November 16, 2006 Stefanchik et al.
20060258910 November 16, 2006 Stefanchik et al.
20060259073 November 16, 2006 Miyamoto et al.
20060264831 November 23, 2006 Skwarek et al.
20060264927 November 23, 2006 Ryan
20060264929 November 23, 2006 Goble et al.
20060271042 November 30, 2006 Latterell et al.
20060271102 November 30, 2006 Bosshard et al.
20060278680 December 14, 2006 Viola et al.
20060278681 December 14, 2006 Viola et al.
20060282064 December 14, 2006 Shimizu et al.
20060284730 December 21, 2006 Schmid et al.
20060287576 December 21, 2006 Tsuji et al.
20060289602 December 28, 2006 Wales et al.
20060291981 December 28, 2006 Viola et al.
20070010702 January 11, 2007 Wang et al.
20070010838 January 11, 2007 Shelton, IV et al.
20070023476 February 1, 2007 Whitman et al.
20070023477 February 1, 2007 Whitman et al.
20070026039 February 1, 2007 Drumheller et al.
20070026040 February 1, 2007 Crawley et al.
20070027468 February 1, 2007 Wales et al.
20070027472 February 1, 2007 Hiles et al.
20070027551 February 1, 2007 Farnsworth et al.
20070027553 February 1, 2007 Biran et al.
20070034668 February 15, 2007 Holsten et al.
20070049951 March 1, 2007 Menn
20070049966 March 1, 2007 Bonadio et al.
20070051375 March 8, 2007 Milliman
20070055219 March 8, 2007 Whitman et al.
20070066981 March 22, 2007 Meagher
20070070574 March 29, 2007 Nerheim et al.
20070073341 March 29, 2007 Smith
20070078328 April 5, 2007 Ozaki et al.
20070078484 April 5, 2007 Talarico et al.
20070083193 April 12, 2007 Werneth et al.
20070084897 April 19, 2007 Shelton, IV et al.
20070090788 April 26, 2007 Hansford et al.
20070093869 April 26, 2007 Bloom et al.
20070102472 May 10, 2007 Shelton, IV
20070106113 May 10, 2007 Ravo
20070106317 May 10, 2007 Shelton, IV et al.
20070118175 May 24, 2007 Butler et al.
20070129605 June 7, 2007 Schaaf
20070131732 June 14, 2007 Holsten
20070135686 June 14, 2007 Pruitt, Jr. et al.
20070135803 June 14, 2007 Belson
20070155010 July 5, 2007 Farnsworth et al.
20070158358 July 12, 2007 Mason, II et al.
20070170225 July 26, 2007 Shelton, IV et al.
20070173687 July 26, 2007 Shima et al.
20070173806 July 26, 2007 Orszulak et al.
20070173813 July 26, 2007 Odom
20070175950 August 2, 2007 Shelton, IV et al.
20070175951 August 2, 2007 Shelton, IV et al.
20070175955 August 2, 2007 Shelton, IV et al.
20070179528 August 2, 2007 Soltz et al.
20070181632 August 9, 2007 Milliman
20070185545 August 9, 2007 Duke
20070190110 August 16, 2007 Pameijer et al.
20070191868 August 16, 2007 Theroux et al.
20070194079 August 23, 2007 Hueil et al.
20070194082 August 23, 2007 Morgan et al.
20070198039 August 23, 2007 Jones et al.
20070203510 August 30, 2007 Bettuchi
20070213750 September 13, 2007 Weadock
20070219571 September 20, 2007 Balbierz et al.
20070225562 September 27, 2007 Spivey et al.
20070233163 October 4, 2007 Bombard et al.
20070239028 October 11, 2007 Houser et al.
20070243227 October 18, 2007 Gertner
20070244471 October 18, 2007 Malackowski
20070246505 October 25, 2007 Pace-Floridia et al.
20070249999 October 25, 2007 Sklar et al.
20070250113 October 25, 2007 Hegeman et al.
20070260278 November 8, 2007 Wheeler et al.
20070270784 November 22, 2007 Smith et al.
20070270884 November 22, 2007 Smith et al.
20070275035 November 29, 2007 Herman et al.
20070276409 November 29, 2007 Ortiz et al.
20070279011 December 6, 2007 Jones et al.
20070286892 December 13, 2007 Herzberg et al.
20070287993 December 13, 2007 Hinman et al.
20070288044 December 13, 2007 Jinno et al.
20070299427 December 27, 2007 Yeung et al.
20080003196 January 3, 2008 Jonn et al.
20080015598 January 17, 2008 Prommersberger
20080029570 February 7, 2008 Shelton et al.
20080029573 February 7, 2008 Shelton et al.
20080029574 February 7, 2008 Shelton et al.
20080029575 February 7, 2008 Shelton et al.
20080030170 February 7, 2008 Dacquay et al.
20080035701 February 14, 2008 Racenet et al.
20080041916 February 21, 2008 Milliman et al.
20080041917 February 21, 2008 Racenet et al.
20080051833 February 28, 2008 Gramuglia et al.
20080065153 March 13, 2008 Allard et al.
20080071328 March 20, 2008 Haubrich et al.
20080078802 April 3, 2008 Hess et al.
20080082114 April 3, 2008 McKenna et al.
20080082125 April 3, 2008 Murray et al.
20080082126 April 3, 2008 Murray et al.
20080083808 April 10, 2008 Scirica
20080083813 April 10, 2008 Zemlok et al.
20080085296 April 10, 2008 Powell et al.
20080086078 April 10, 2008 Powell et al.
20080091072 April 17, 2008 Omori et al.
20080097563 April 24, 2008 Petrie et al.
20080108443 May 8, 2008 Jinno et al.
20080114250 May 15, 2008 Urbano et al.
20080114315 May 15, 2008 Voegele et al.
20080114385 May 15, 2008 Byrum et al.
20080128469 June 5, 2008 Dalessandro et al.
20080129253 June 5, 2008 Shiue et al.
20080140115 June 12, 2008 Stopek
20080140159 June 12, 2008 Bornhoft et al.
20080154299 June 26, 2008 Linvneh
20080169328 July 17, 2008 Shelton
20080169332 July 17, 2008 Shelton et al.
20080169333 July 17, 2008 Shelton et al.
20080172087 July 17, 2008 Fuchs et al.
20080172088 July 17, 2008 Smith et al.
20080183193 July 31, 2008 Omori et al.
20080185419 August 7, 2008 Smith et al.
20080190989 August 14, 2008 Crews et al.
20080197167 August 21, 2008 Viola et al.
20080200762 August 21, 2008 Stokes et al.
20080200835 August 21, 2008 Monson et al.
20080200933 August 21, 2008 Bakos et al.
20080200949 August 21, 2008 Hiles et al.
20080228029 September 18, 2008 Mikkaichi et al.
20080241667 October 2, 2008 Kohn et al.
20080245841 October 9, 2008 Smith et al.
20080249536 October 9, 2008 Stahler et al.
20080249608 October 9, 2008 Dave
20080251568 October 16, 2008 Zemlok et al.
20080251569 October 16, 2008 Smith et al.
20080255413 October 16, 2008 Zemlok et al.
20080255607 October 16, 2008 Zemlok
20080262654 October 23, 2008 Omori et al.
20080281171 November 13, 2008 Fennell et al.
20080281254 November 13, 2008 Humayun et al.
20080283570 November 20, 2008 Boyden et al.
20080287944 November 20, 2008 Pearson et al.
20080287988 November 20, 2008 Smith et al.
20080290134 November 27, 2008 Bettuchi et al.
20080294179 November 27, 2008 Balbierz et al.
20080296346 December 4, 2008 Shelton, IV et al.
20080297287 December 4, 2008 Shachar et al.
20080308602 December 18, 2008 Timm et al.
20080308603 December 18, 2008 Shelton, IV et al.
20080308608 December 18, 2008 Prommersberger
20080314960 December 25, 2008 Marczyk et al.
20080315829 December 25, 2008 Jones et al.
20090001121 January 1, 2009 Hess et al.
20090001130 January 1, 2009 Hess et al.
20090004455 January 1, 2009 Gravagna et al.
20090005809 January 1, 2009 Hess et al.
20090012534 January 8, 2009 Madhani et al.
20090015195 January 15, 2009 Loth-Krausser
20090018553 January 15, 2009 McLean et al.
20090020958 January 22, 2009 Soul
20090047329 February 19, 2009 Stucky et al.
20090048589 February 19, 2009 Takashino et al.
20090048612 February 19, 2009 Farritor et al.
20090054908 February 26, 2009 Zand et al.
20090069842 March 12, 2009 Lee et al.
20090076506 March 19, 2009 Baker
20090078736 March 26, 2009 Van Lue
20090082789 March 26, 2009 Milliman et al.
20090088659 April 2, 2009 Graham et al.
20090088774 April 2, 2009 Swarup et al.
20090090763 April 9, 2009 Zemlok et al.
20090092651 April 9, 2009 Shah et al.
20090093728 April 9, 2009 Hyde et al.
20090099579 April 16, 2009 Nentwick et al.
20090099876 April 16, 2009 Whitman
20090108048 April 30, 2009 Zemlok et al.
20090112229 April 30, 2009 Omori et al.
20090114701 May 7, 2009 Zemlok et al.
20090119011 May 7, 2009 Kondo et al.
20090137952 May 28, 2009 Ramamurthy et al.
20090143805 June 4, 2009 Palmer et al.
20090143855 June 4, 2009 Weber et al.
20090149871 June 11, 2009 Kagan et al.
20090157067 June 18, 2009 Kane et al.
20090157087 June 18, 2009 Wei et al.
20090171147 July 2, 2009 Lee et al.
20090177226 July 9, 2009 Reinprecht et al.
20090179757 July 16, 2009 Cohn et al.
20090188964 July 30, 2009 Orlov
20090198272 August 6, 2009 Kerver et al.
20090204108 August 13, 2009 Steffen
20090204109 August 13, 2009 Grove et al.
20090206125 August 20, 2009 Huitema et al.
20090206126 August 20, 2009 Huitema et al.
20090206131 August 20, 2009 Weisenburgh, II et al.
20090206133 August 20, 2009 Morgan et al.
20090206137 August 20, 2009 Hall et al.
20090206139 August 20, 2009 Hall
20090206141 August 20, 2009 Huitema et al.
20090206142 August 20, 2009 Huitema et al.
20090213685 August 27, 2009 Mak et al.
20090234273 September 17, 2009 Intoccia et al.
20090242610 October 1, 2009 Shelton, IV et al.
20090247368 October 1, 2009 Chiang
20090247901 October 1, 2009 Zimmer
20090248007 October 1, 2009 Falkenstein et al.
20090248038 October 1, 2009 Blumenkranz et al.
20090253959 October 8, 2009 Yoshie et al.
20090255974 October 15, 2009 Viola
20090255975 October 15, 2009 Zemlok et al.
20090255976 October 15, 2009 Marczyk et al.
20090255977 October 15, 2009 Zemlok
20090255978 October 15, 2009 Viola et al.
20090262078 October 22, 2009 Pizzi
20090270895 October 29, 2009 Churchill et al.
20090277949 November 12, 2009 Viola et al.
20090290016 November 26, 2009 Suda
20090292283 November 26, 2009 Odom
20090306639 December 10, 2009 Nevo et al.
20090308907 December 17, 2009 Nalagatla et al.
20100010511 January 14, 2010 Harris et al.
20100012704 January 21, 2010 Racenet et al.
20100016852 January 21, 2010 Manzo et al.
20100016888 January 21, 2010 Calabrese et al.
20100023024 January 28, 2010 Zeiner et al.
20100036370 February 11, 2010 Mirel et al.
20100041945 February 18, 2010 Isbell, Jr.
20100049084 February 25, 2010 Nock et al.
20100057087 March 4, 2010 Cha
20100057107 March 4, 2010 Sorrentino et al.
20100065606 March 18, 2010 Stopek
20100069942 March 18, 2010 Shelton, IV
20100072254 March 25, 2010 Aranyi et al.
20100076483 March 25, 2010 Imuta
20100076489 March 25, 2010 Stopek et al.
20100081883 April 1, 2010 Murray et al.
20100087840 April 8, 2010 Ebersole et al.
20100094289 April 15, 2010 Taylor et al.
20100096431 April 22, 2010 Smith et al.
20100100124 April 22, 2010 Calabrese et al.
20100108740 May 6, 2010 Pastorelli et al.
20100108741 May 6, 2010 Hessler et al.
20100122339 May 13, 2010 Boccacci
20100133317 June 3, 2010 Shelton, IV et al.
20100145146 June 10, 2010 Melder
20100147921 June 17, 2010 Olson
20100147922 June 17, 2010 Olson
20100147923 June 17, 2010 D'Agostino et al.
20100163598 July 1, 2010 Belzer
20100179022 July 15, 2010 Shirokoshi
20100179540 July 15, 2010 Marczyk et al.
20100180711 July 22, 2010 Kilibarda et al.
20100186219 July 29, 2010 Smith
20100191292 July 29, 2010 DeMeo et al.
20100193566 August 5, 2010 Schieb et al.
20100200637 August 12, 2010 Beetel
20100204717 August 12, 2010 Knodel
20100222901 September 2, 2010 Swayze et al.
20100230465 September 16, 2010 Smith et al.
20100243707 September 30, 2010 Olson et al.
20100243708 September 30, 2010 Aranyi et al.
20100249497 September 30, 2010 Peine et al.
20100249519 September 30, 2010 Park et al.
20100249759 September 30, 2010 Hinman et al.
20100258611 October 14, 2010 Smith et al.
20100267662 October 21, 2010 Fielder et al.
20100268030 October 21, 2010 Viola et al.
20100274160 October 28, 2010 Yachi et al.
20100276471 November 4, 2010 Whitman
20100292540 November 18, 2010 Hess et al.
20100294827 November 25, 2010 Boyden et al.
20100298636 November 25, 2010 Casto et al.
20100312261 December 9, 2010 Suzuki et al.
20100320252 December 23, 2010 Viola et al.
20100331856 December 30, 2010 Carlson et al.
20100331880 December 30, 2010 Stopek
20110003528 January 6, 2011 Lam
20110006101 January 13, 2011 Hall et al.
20110009890 January 13, 2011 Palmer et al.
20110011916 January 20, 2011 Levine
20110016960 January 27, 2011 Debrailly
20110017799 January 27, 2011 Whitman et al.
20110021871 January 27, 2011 Berkelaar
20110022032 January 27, 2011 Zemlok et al.
20110024477 February 3, 2011 Hall et al.
20110024478 February 3, 2011 Shelton, IV
20110025311 February 3, 2011 Chauvin et al.
20110034910 February 10, 2011 Ross et al.
20110034918 February 10, 2011 Reschke
20110036887 February 17, 2011 Zemlok et al.
20110036890 February 17, 2011 Ma
20110036891 February 17, 2011 Zemlok et al.
20110045047 February 24, 2011 Bennett et al.
20110046666 February 24, 2011 Sorrentino et al.
20110046667 February 24, 2011 Culligan et al.
20110060356 March 10, 2011 Reschke et al.
20110060363 March 10, 2011 Hess et al.
20110082538 April 7, 2011 Dahlgren et al.
20110084112 April 14, 2011 Kostrzewski
20110087276 April 14, 2011 Bedi et al.
20110087279 April 14, 2011 Shah et al.
20110088921 April 21, 2011 Forgues et al.
20110095068 April 28, 2011 Patel
20110101065 May 5, 2011 Milliman
20110101069 May 5, 2011 Bombard et al.
20110112517 May 12, 2011 Peine et al.
20110114697 May 19, 2011 Baxter, III et al.
20110118778 May 19, 2011 Burbank
20110121049 May 26, 2011 Malinouskas et al.
20110125138 May 26, 2011 Malinouskas et al.
20110125176 May 26, 2011 Yates et al.
20110144640 June 16, 2011 Heinrich et al.
20110147433 June 23, 2011 Shelton, IV et al.
20110155786 June 30, 2011 Shelton, IV
20110163146 July 7, 2011 Ortiz et al.
20110167619 July 14, 2011 Smith et al.
20110174099 July 21, 2011 Ross et al.
20110174861 July 21, 2011 Shelton, IV et al.
20110178536 July 21, 2011 Kostrzewski
20110184459 July 28, 2011 Malkowski et al.
20110192882 August 11, 2011 Hess et al.
20110199225 August 18, 2011 Touchberry et al.
20110208093 August 25, 2011 Gross et al.
20110210156 September 1, 2011 Smith et al.
20110218550 September 8, 2011 Ma
20110241597 October 6, 2011 Zhu et al.
20110253765 October 20, 2011 Nicholas et al.
20110257650 October 20, 2011 Deville et al.
20110264119 October 27, 2011 Bayon et al.
20110275901 November 10, 2011 Shelton, IV
20110276083 November 10, 2011 Shelton, IV et al.
20110278343 November 17, 2011 Knodel et al.
20110279268 November 17, 2011 Konishi et al.
20110282446 November 17, 2011 Schulte et al.
20110290856 December 1, 2011 Shelton, IV et al.
20110293690 December 1, 2011 Griffin et al.
20110295295 December 1, 2011 Shelton, IV et al.
20110307023 December 15, 2011 Tweden et al.
20110313894 December 22, 2011 Dye et al.
20110315413 December 29, 2011 Fisher et al.
20120004636 January 5, 2012 Lo
20120007550 January 12, 2012 Juergens
20120016239 January 19, 2012 Barthe et al.
20120016413 January 19, 2012 Timm et al.
20120018326 January 26, 2012 Racenet et al.
20120022523 January 26, 2012 Smith et al.
20120022630 January 26, 2012 Wübbeling
20120029272 February 2, 2012 Shelton, IV et al.
20120033360 February 9, 2012 Hsu
20120045303 February 23, 2012 Macdonald
20120046692 February 23, 2012 Smith et al.
20120062171 March 15, 2012 Smith et al.
20120064483 March 15, 2012 Lint et al.
20120074200 March 29, 2012 Schmid et al.
20120078071 March 29, 2012 Bohm et al.
20120078244 March 29, 2012 Worrell et al.
20120078278 March 29, 2012 Bales, Jr. et al.
20120080336 April 5, 2012 Shelton, IV et al.
20120080340 April 5, 2012 Shelton, IV et al.
20120080344 April 5, 2012 Shelton, IV
20120080475 April 5, 2012 Smith et al.
20120080478 April 5, 2012 Morgan et al.
20120080498 April 5, 2012 Shelton, IV et al.
20120089131 April 12, 2012 Zemlok et al.
20120110810 May 10, 2012 Houser et al.
20120116265 May 10, 2012 Houser et al.
20120116367 May 10, 2012 Houser et al.
20120116388 May 10, 2012 Houser et al.
20120116391 May 10, 2012 Houser et al.
20120116395 May 10, 2012 Madan et al.
20120123203 May 17, 2012 Riva
20120125792 May 24, 2012 Cassivi
20120138658 June 7, 2012 Ullrich et al.
20120171539 July 5, 2012 Rejman et al.
20120175398 July 12, 2012 Sandborn et al.
20120187179 July 26, 2012 Gleiman
20120209289 August 16, 2012 Duque et al.
20120223121 September 6, 2012 Viola et al.
20120228355 September 13, 2012 Combrowski et al.
20120234895 September 20, 2012 O'Connor et al.
20120234897 September 20, 2012 Shelton, IV et al.
20120234899 September 20, 2012 Scheib et al.
20120241492 September 27, 2012 Shelton, IV et al.
20120241493 September 27, 2012 Baxter, III et al.
20120248167 October 4, 2012 Flanagan et al.
20120248169 October 4, 2012 Widenhouse et al.
20120251861 October 4, 2012 Liang et al.
20120253329 October 4, 2012 Zemlok et al.
20120265176 October 18, 2012 Braun
20120271285 October 25, 2012 Sholev et al.
20120273550 November 1, 2012 Scirica
20120277780 November 1, 2012 Smith et al.
20120283707 November 8, 2012 Giordano et al.
20120286021 November 15, 2012 Kostrzewski et al.
20120289979 November 15, 2012 Eskaros et al.
20120292367 November 22, 2012 Morgan et al.
20120296333 November 22, 2012 Twomey
20120298722 November 29, 2012 Hess et al.
20120310255 December 6, 2012 Brisson et al.
20120310256 December 6, 2012 Brisson
20120325892 December 27, 2012 Kostrzewski
20130012983 January 10, 2013 Kleyman
20130018361 January 17, 2013 Bryant
20130020375 January 24, 2013 Shelton, IV et al.
20130020376 January 24, 2013 Shelton, IV et al.
20130023861 January 24, 2013 Shelton, IV et al.
20130026208 January 31, 2013 Shelton, IV et al.
20130026210 January 31, 2013 Shelton, IV et al.
20130026973 January 31, 2013 Luke et al.
20130030608 January 31, 2013 Taylor et al.
20130032626 February 7, 2013 Smith et al.
20130037596 February 14, 2013 Bear et al.
20130046290 February 21, 2013 Palmer et al.
20130060278 March 7, 2013 Bozung et al.
20130062391 March 14, 2013 Boudreaux et al.
20130068816 March 21, 2013 Mandakolathur Vasudevan et al.
20130075446 March 28, 2013 Wang et al.
20130079814 March 28, 2013 Hess et al.
20130087597 April 11, 2013 Shelton, IV et al.
20130087599 April 11, 2013 Krumanaker et al.
20130087602 April 11, 2013 Olson et al.
20130090534 April 11, 2013 Burns et al.
20130098970 April 25, 2013 Racenet et al.
20130103023 April 25, 2013 Monson et al.
20130103024 April 25, 2013 Monson et al.
20130105548 May 2, 2013 Hodgkinson et al.
20130116668 May 9, 2013 Shelton, IV et al.
20130116669 May 9, 2013 Shelton, IV et al.
20130119108 May 16, 2013 Altman et al.
20130123822 May 16, 2013 Wellman et al.
20130126379 May 23, 2013 Medhal et al.
20130131476 May 23, 2013 Siu et al.
20130131651 May 23, 2013 Strobl et al.
20130146641 June 13, 2013 Shelton, IV et al.
20130146642 June 13, 2013 Shelton, IV et al.
20130150832 June 13, 2013 Belson et al.
20130153633 June 20, 2013 Casasanta, Jr. et al.
20130153634 June 20, 2013 Carter et al.
20130153635 June 20, 2013 Hodgkinson
20130153636 June 20, 2013 Shelton, IV et al.
20130153638 June 20, 2013 Carter et al.
20130153641 June 20, 2013 Shelton, IV et al.
20130168431 July 4, 2013 Zemlok et al.
20130172929 July 4, 2013 Hess et al.
20130175317 July 11, 2013 Yates et al.
20130175322 July 11, 2013 Yates et al.
20130181033 July 18, 2013 Shelton, IV et al.
20130181034 July 18, 2013 Shelton, IV et al.
20130186933 July 25, 2013 Shelton, IV et al.
20130186934 July 25, 2013 Shelton, IV et al.
20130190733 July 25, 2013 Giordano et al.
20130190757 July 25, 2013 Yates et al.
20130193188 August 1, 2013 Shelton, IV et al.
20130193189 August 1, 2013 Swensgard et al.
20130197556 August 1, 2013 Shelton, IV et al.
20130214025 August 22, 2013 Zemlok et al.
20130214030 August 22, 2013 Aronhalt et al.
20130221059 August 29, 2013 Racenet et al.
20130221063 August 29, 2013 Aronhalt et al.
20130221064 August 29, 2013 Aronhalt et al.
20130221065 August 29, 2013 Aronhalt et al.
20130233905 September 12, 2013 Sorrentino et al.
20130233906 September 12, 2013 Hess et al.
20130233908 September 12, 2013 Knodel et al.
20130238021 September 12, 2013 Gross et al.
20130256371 October 3, 2013 Shelton, IV et al.
20130256373 October 3, 2013 Schmid et al.
20130256374 October 3, 2013 Shelton, IV et al.
20130256375 October 3, 2013 Shelton, IV et al.
20130256377 October 3, 2013 Schmid et al.
20130256378 October 3, 2013 Schmid et al.
20130256379 October 3, 2013 Schmid et al.
20130256380 October 3, 2013 Schmid et al.
20130256382 October 3, 2013 Swayze et al.
20130256383 October 3, 2013 Aronhalt et al.
20130261648 October 3, 2013 Laurent et al.
20130267945 October 10, 2013 Behnke et al.
20130270322 October 17, 2013 Scheib et al.
20130277412 October 24, 2013 Gresham et al.
20130282052 October 24, 2013 Aranyi et al.
20130310873 November 21, 2013 Stopek et al.
20130313304 November 28, 2013 Shelton, IV et al.
20130313306 November 28, 2013 Shelton, IV et al.
20130319706 December 5, 2013 Nicholas et al.
20130324981 December 5, 2013 Smith et al.
20130324982 December 5, 2013 Smith et al.
20130327809 December 12, 2013 Shelton, IV et al.
20130327810 December 12, 2013 Swayze et al.
20130334283 December 19, 2013 Swayze et al.
20130334284 December 19, 2013 Swayze et al.
20130334285 December 19, 2013 Swayze et al.
20130334286 December 19, 2013 Swayze et al.
20130334287 December 19, 2013 Shelton, IV
20130334288 December 19, 2013 Shelton, IV
20130341374 December 26, 2013 Shelton, IV et al.
20140001231 January 2, 2014 Shelton, IV et al.
20140001234 January 2, 2014 Shelton, IV et al.
20140001237 January 2, 2014 Shelton, IV et al.
20140001238 January 2, 2014 Shelton, IV et al.
20140001239 January 2, 2014 Shelton, IV et al.
20140001240 January 2, 2014 Shelton, IV et al.
20140005640 January 2, 2014 Shelton, IV et al.
20140005678 January 2, 2014 Shelton, IV et al.
20140005681 January 2, 2014 Gee et al.
20140005693 January 2, 2014 Shelton, IV et al.
20140005694 January 2, 2014 Shelton, IV et al.
20140005702 January 2, 2014 Timm et al.
20140005703 January 2, 2014 Stulen et al.
20140005718 January 2, 2014 Shelton, IV et al.
20140008414 January 9, 2014 Shelton, IV et al.
20140012237 January 9, 2014 Pribanic et al.
20140012238 January 9, 2014 Chen et al.
20140012289 January 9, 2014 Snow et al.
20140014705 January 16, 2014 Baxter, III
20140015782 January 16, 2014 Kim et al.
20140018832 January 16, 2014 Shelton, IV
20140025046 January 23, 2014 Williams et al.
20140042205 February 13, 2014 Baxter, III et al.
20140048580 February 20, 2014 Merchant et al.
20140061279 March 6, 2014 Laurent et al.
20140061280 March 6, 2014 Ingmanson et al.
20140081176 March 20, 2014 Hassan
20140100558 April 10, 2014 Schmitz et al.
20140103093 April 17, 2014 Koch, Jr. et al.
20140107640 April 17, 2014 Yates et al.
20140110455 April 24, 2014 Ingmanson et al.
20140114327 April 24, 2014 Boudreaux et al.
20140128850 May 8, 2014 Kerr et al.
20140138423 May 22, 2014 Whitfield et al.
20140151431 June 5, 2014 Hodgkinson et al.
20140151433 June 5, 2014 Shelton, IV et al.
20140158747 June 12, 2014 Measamer et al.
20140166722 June 19, 2014 Hess et al.
20140166724 June 19, 2014 Schellin et al.
20140166725 June 19, 2014 Schellin et al.
20140166726 June 19, 2014 Schellin et al.
20140171966 June 19, 2014 Giordano et al.
20140175150 June 26, 2014 Shelton et al.
20140175152 June 26, 2014 Hess et al.
20140175154 June 26, 2014 Shelton, IV et al.
20140191014 July 10, 2014 Shelton, IV
20140191015 July 10, 2014 Shelton, IV
20140203061 July 24, 2014 Hodgkinson
20140205637 July 24, 2014 Widenhouse et al.
20140207125 July 24, 2014 Applegate et al.
20140207166 July 24, 2014 Shelton, IV et al.
20140224857 August 14, 2014 Schmid
20140230595 August 21, 2014 Butt et al.
20140232316 August 21, 2014 Philipp
20140236184 August 21, 2014 Leimbach et al.
20140239036 August 28, 2014 Zerkle et al.
20140239038 August 28, 2014 Leimbach et al.
20140246472 September 4, 2014 Kimsey et al.
20140246475 September 4, 2014 Hall et al.
20140249557 September 4, 2014 Koch, Jr. et al.
20140252066 September 11, 2014 Shelton, IV et al.
20140252068 September 11, 2014 Shelton, IV et al.
20140259591 September 18, 2014 Shelton, IV et al.
20140263541 September 18, 2014 Leimbach et al.
20140263552 September 18, 2014 Hall et al.
20140263554 September 18, 2014 Leimbach et al.
20140263558 September 18, 2014 Hausen et al.
20140263562 September 18, 2014 Patel et al.
20140263564 September 18, 2014 Leimbach et al.
20140263572 September 18, 2014 Shelton, IV et al.
20140276730 September 18, 2014 Boudreaux et al.
20140277017 September 18, 2014 Leimbach et al.
20140284371 September 25, 2014 Morgan et al.
20140284373 September 25, 2014 Shelton, IV et al.
20140288460 September 25, 2014 Ouyang et al.
20140291378 October 2, 2014 Shelton, IV et al.
20140291379 October 2, 2014 Schellin et al.
20140291380 October 2, 2014 Weaner et al.
20140291382 October 2, 2014 Lloyd et al.
20140291383 October 2, 2014 Spivey et al.
20140296873 October 2, 2014 Morgan et al.
20140296874 October 2, 2014 Morgan et al.
20140299648 October 9, 2014 Shelton, IV et al.
20140303645 October 9, 2014 Morgan et al.
20140303646 October 9, 2014 Morgan et al.
20140305987 October 16, 2014 Parihar et al.
20140305988 October 16, 2014 Boudreaux et al.
20140305989 October 16, 2014 Parihar et al.
20140305990 October 16, 2014 Shelton, IV et al.
20140305991 October 16, 2014 Parihar et al.
20140305992 October 16, 2014 Kimsey et al.
20140305994 October 16, 2014 Parihar et al.
20140309665 October 16, 2014 Parihar et al.
20140309666 October 16, 2014 Shelton, IV et al.
20140330161 November 6, 2014 Swayze et al.
20140339286 November 20, 2014 Motooka et al.
20140352463 December 4, 2014 Parihar
20140353358 December 4, 2014 Shelton, IV et al.
20140367447 December 18, 2014 Woodard, Jr. et al.
20140378950 December 25, 2014 Chiu
20150008248 January 8, 2015 Giordano et al.
20150034696 February 5, 2015 Shelton, IV et al.
20150038986 February 5, 2015 Swensgard et al.
20150041518 February 12, 2015 Shelton, IV et al.
20150053737 February 26, 2015 Leimbach et al.
20150053738 February 26, 2015 Morgan et al.
20150053739 February 26, 2015 Morgan et al.
20150053740 February 26, 2015 Shelton, IV
20150053741 February 26, 2015 Shelton, IV et al.
20150053742 February 26, 2015 Shelton, IV et al.
20150053743 February 26, 2015 Yates et al.
20150053744 February 26, 2015 Swayze et al.
20150053745 February 26, 2015 Yates et al.
20150053746 February 26, 2015 Shelton, IV et al.
20150053748 February 26, 2015 Yates et al.
20150060518 March 5, 2015 Shelton, IV et al.
20150060519 March 5, 2015 Shelton, IV et al.
20150060520 March 5, 2015 Shelton, IV et al.
20150060521 March 5, 2015 Weisenburgh, II et al.
20150076207 March 19, 2015 Boudreaux et al.
20150076208 March 19, 2015 Shelton, IV
20150076209 March 19, 2015 Shelton, IV et al.
20150076210 March 19, 2015 Shelton, IV et al.
20150076212 March 19, 2015 Shelton, IV
20150080868 March 19, 2015 Kerr
20150083780 March 26, 2015 Shelton, IV et al.
20150083781 March 26, 2015 Giordano et al.
20150083782 March 26, 2015 Scheib et al.
20150083783 March 26, 2015 Shelton, IV et al.
20150090759 April 2, 2015 Spivey et al.
20150090760 April 2, 2015 Giordano et al.
20150090761 April 2, 2015 Giordano et al.
20150090762 April 2, 2015 Giordano et al.
20150090763 April 2, 2015 Murray et al.
20150108199 April 23, 2015 Shelton, IV et al.
20150122869 May 7, 2015 Aronhalt et al.
20150136830 May 21, 2015 Baxter, III et al.
20150136831 May 21, 2015 Baxter, III et al.
20150136832 May 21, 2015 Baxter, III et al.
20150136833 May 21, 2015 Shelton, IV et al.
20150136835 May 21, 2015 Shelton, IV et al.
20150157354 June 11, 2015 Bales, Jr. et al.
20150173744 June 25, 2015 Shelton, IV et al.
20150173745 June 25, 2015 Baxter, III et al.
20150173746 June 25, 2015 Baxter, III et al.
20150173747 June 25, 2015 Baxter, III et al.
20150173749 June 25, 2015 Shelton, IV et al.
20150173750 June 25, 2015 Shelton, IV et al.
20150173751 June 25, 2015 Shelton, IV et al.
20150173755 June 25, 2015 Baxter, III et al.
20150173756 June 25, 2015 Baxter, III et al.
20150173760 June 25, 2015 Shelton, IV et al.
20150173761 June 25, 2015 Shelton, IV et al.
20150173762 June 25, 2015 Shelton, IV et al.
20150173789 June 25, 2015 Baxter, III et al.
20150182220 July 2, 2015 Yates et al.
20150182222 July 2, 2015 Swayze et al.
20150196295 July 16, 2015 Shelton, IV et al.
20150196296 July 16, 2015 Swayze et al.
20150196299 July 16, 2015 Swayze et al.
20150196347 July 16, 2015 Yates et al.
20150196348 July 16, 2015 Yates et al.
20150201932 July 23, 2015 Swayze et al.
20150201935 July 23, 2015 Weisenburgh, II et al.
20150201936 July 23, 2015 Swayze et al.
20150201937 July 23, 2015 Swayze et al.
20150201938 July 23, 2015 Swayze et al.
20150201939 July 23, 2015 Swayze et al.
20150201940 July 23, 2015 Swayze et al.
20150201941 July 23, 2015 Swayze et al.
20150209031 July 30, 2015 Shelton, IV et al.
20150209038 July 30, 2015 Shelton, IV et al.
20150209039 July 30, 2015 Shelton, IV et al.
20150209041 July 30, 2015 Milliman et al.
20150223809 August 13, 2015 Scheib et al.
20150223816 August 13, 2015 Morgan et al.
20150230783 August 20, 2015 Shelton, IV et al.
20150230784 August 20, 2015 Shelton, IV et al.
20150231409 August 20, 2015 Racenet et al.
20150239180 August 27, 2015 Schellin et al.
20150265276 September 24, 2015 Huitema et al.
20150265357 September 24, 2015 Shelton, IV et al.
20150272557 October 1, 2015 Overmyer et al.
20150272569 October 1, 2015 Leimbach et al.
20150272570 October 1, 2015 Lytle, IV et al.
20150272571 October 1, 2015 Leimbach et al.
20150272572 October 1, 2015 Overmyer et al.
20150272574 October 1, 2015 Leimbach et al.
20150272575 October 1, 2015 Leimbach et al.
20150272578 October 1, 2015 Leimbach et al.
20150272579 October 1, 2015 Leimbach et al.
20150272580 October 1, 2015 Leimbach et al.
20150272581 October 1, 2015 Leimbach et al.
20150272582 October 1, 2015 Leimbach et al.
20150272583 October 1, 2015 Leimbach et al.
20150277471 October 1, 2015 Leimbach et al.
20150280384 October 1, 2015 Leimbach et al.
20150280424 October 1, 2015 Leimbach et al.
20150282809 October 8, 2015 Shelton, IV et al.
20150282810 October 8, 2015 Shelton, IV et al.
20150289873 October 15, 2015 Shelton, IV et al.
20150289874 October 15, 2015 Leimbach et al.
20150297210 October 22, 2015 Widenhouse et al.
20150297217 October 22, 2015 Huitema et al.
20150297218 October 22, 2015 Shelton, IV et al.
20150297219 October 22, 2015 Shelton, IV et al.
20150297221 October 22, 2015 Kerr et al.
20150297222 October 22, 2015 Huitema et al.
20150297223 October 22, 2015 Huitema et al.
20150297224 October 22, 2015 Hall et al.
20150297225 October 22, 2015 Huitema et al.
20150297226 October 22, 2015 Hall et al.
20150297227 October 22, 2015 Huitema et al.
20150297228 October 22, 2015 Huitema et al.
20150297229 October 22, 2015 Schellin et al.
20150297230 October 22, 2015 Schellin et al.
20150297231 October 22, 2015 Huitema et al.
20150297232 October 22, 2015 Huitema et al.
20150297233 October 22, 2015 Huitema et al.
20150297234 October 22, 2015 Schellin et al.
20150297235 October 22, 2015 Harris et al.
20150297236 October 22, 2015 Harris et al.
20150305744 October 29, 2015 Moore et al.
20150305745 October 29, 2015 Baxter, III et al.
20150313591 November 5, 2015 Baxter, III et al.
20150313594 November 5, 2015 Shelton, IV et al.
20150327853 November 19, 2015 Aronhalt et al.
20150327864 November 19, 2015 Hodgkinson et al.
20150335328 November 26, 2015 Shelton, IV et al.
20150335329 November 26, 2015 Shelton, IV et al.
20150342606 December 3, 2015 Schmid et al.
20150342607 December 3, 2015 Shelton, IV et al.
20150359536 December 17, 2015 Cropper et al.
20150374367 December 31, 2015 Hall et al.
20150374368 December 31, 2015 Swayze et al.
20150374369 December 31, 2015 Yates et al.
20150374374 December 31, 2015 Shelton, IV et al.
20150374375 December 31, 2015 Shelton, IV et al.
20150374376 December 31, 2015 Shelton, IV
20150374377 December 31, 2015 Shelton, IV
20150374378 December 31, 2015 Giordano et al.
20150374379 December 31, 2015 Shelton, IV
20160000430 January 7, 2016 Ming et al.
20160000431 January 7, 2016 Giordano et al.
20160000432 January 7, 2016 Huang et al.
20160000437 January 7, 2016 Giordano et al.
20160000438 January 7, 2016 Swayze et al.
20160000439 January 7, 2016 Weisenburgh, II et al.
20160000440 January 7, 2016 Weisenburgh, II et al.
20160000441 January 7, 2016 Shelton, IV et al.
20160000442 January 7, 2016 Shelton, IV
20160000452 January 7, 2016 Yates et al.
20160000453 January 7, 2016 Yates et al.
20160000513 January 7, 2016 Shelton, IV et al.
20160007992 January 14, 2016 Yates et al.
20160008023 January 14, 2016 Yates et al.
20160015390 January 21, 2016 Timm et al.
20160015391 January 21, 2016 Shelton, IV et al.
20160051257 February 25, 2016 Shelton, IV et al.
20160058443 March 3, 2016 Yates et al.
20160066911 March 10, 2016 Baber et al.
20160066912 March 10, 2016 Baber et al.
20160066913 March 10, 2016 Swayze et al.
20160066915 March 10, 2016 Baber et al.
20160069449 March 10, 2016 Kanai et al.
20160074038 March 17, 2016 Leimbach et al.
20160074040 March 17, 2016 Widenhouse et al.
20160089137 March 31, 2016 Hess et al.
20160089141 March 31, 2016 Harris et al.
20160089142 March 31, 2016 Harris et al.
20160089143 March 31, 2016 Harris et al.
20160089146 March 31, 2016 Harris et al.
20160089147 March 31, 2016 Harris et al.
20160089148 March 31, 2016 Harris et al.
20160089149 March 31, 2016 Harris et al.
20160100837 April 14, 2016 Huang et al.
20160106426 April 21, 2016 Shelton, IV et al.
20160106427 April 21, 2016 Shelton, IV et al.
20160106431 April 21, 2016 Shelton, IV et al.
20160113653 April 28, 2016 Zingman
20160120544 May 5, 2016 Shelton, IV et al.
20160120545 May 5, 2016 Shelton, IV et al.
20160120547 May 5, 2016 Schmid et al.
20160128694 May 12, 2016 Baxter, III et al.
20160135812 May 19, 2016 Shelton, IV et al.
20160166256 June 16, 2016 Baxter, III et al.
20160174969 June 23, 2016 Kerr et al.
20160174970 June 23, 2016 Shelton, IV et al.
20160174971 June 23, 2016 Baxter, III et al.
20160174972 June 23, 2016 Shelton, IV et al.
20160174973 June 23, 2016 Shelton, IV et al.
20160174974 June 23, 2016 Schmid et al.
20160174975 June 23, 2016 Shelton, IV et al.
20160174976 June 23, 2016 Morgan et al.
20160174983 June 23, 2016 Shelton, IV et al.
20160174984 June 23, 2016 Smith et al.
20160174985 June 23, 2016 Baxter, III et al.
20160183939 June 30, 2016 Shelton, IV et al.
20160183943 June 30, 2016 Shelton, IV
20160183944 June 30, 2016 Swensgard et al.
20160183945 June 30, 2016 Shelton, IV et al.
20160183947 June 30, 2016 Shelton, IV et al.
20160183948 June 30, 2016 Shelton, IV et al.
20160183950 June 30, 2016 Shelton, IV et al.
20160184039 June 30, 2016 Shelton, IV et al.
20160192916 July 7, 2016 Shelton, IV et al.
20160192917 July 7, 2016 Shelton, IV et al.
20160192918 July 7, 2016 Shelton, IV et al.
20160192929 July 7, 2016 Schmid et al.
20160192933 July 7, 2016 Shelton, IV
20160192936 July 7, 2016 Leimbach et al.
20160192996 July 7, 2016 Spivey et al.
20160192997 July 7, 2016 Spivey et al.
20160199059 July 14, 2016 Shelton, IV et al.
20160199061 July 14, 2016 Shelton, IV et al.
20160199063 July 14, 2016 Mandakolathur Vasudevan et al.
20160199064 July 14, 2016 Shelton, IV et al.
20160199088 July 14, 2016 Shelton, IV et al.
20160199089 July 14, 2016 Hess et al.
20160199956 July 14, 2016 Shelton, IV et al.
20160206309 July 21, 2016 Hess et al.
20160206310 July 21, 2016 Shelton, IV
20160206314 July 21, 2016 Scheib et al.
20160220246 August 4, 2016 Timm et al.
20160220247 August 4, 2016 Timm et al.
20160220248 August 4, 2016 Timm et al.
20160220249 August 4, 2016 Shelton, IV et al.
20160220254 August 4, 2016 Baxter, III et al.
20160220266 August 4, 2016 Shelton, IV et al.
20160220268 August 4, 2016 Shelton, IV et al.
20160235403 August 18, 2016 Shelton, IV et al.
20160235404 August 18, 2016 Shelton, IV
20160235405 August 18, 2016 Shelton, IV et al.
20160235406 August 18, 2016 Shelton, IV et al.
20160235408 August 18, 2016 Shelton, IV et al.
20160235409 August 18, 2016 Shelton, IV et al.
20160235494 August 18, 2016 Shelton, IV et al.
20160238108 August 18, 2016 Kanai et al.
20160242768 August 25, 2016 Moore et al.
20160242769 August 25, 2016 Moore et al.
20160242770 August 25, 2016 Moore et al.
20160242775 August 25, 2016 Shelton, IV et al.
20160242776 August 25, 2016 Shelton, IV et al.
20160242777 August 25, 2016 Shelton, IV et al.
20160242780 August 25, 2016 Shelton, IV et al.
20160242781 August 25, 2016 Shelton, IV et al.
20160242782 August 25, 2016 Shelton, IV et al.
20160242783 August 25, 2016 Shelton, IV et al.
20160249908 September 1, 2016 Shelton, IV et al.
20160249909 September 1, 2016 Shelton, IV et al.
20160249910 September 1, 2016 Shelton, IV et al.
20160249911 September 1, 2016 Timm et al.
20160249915 September 1, 2016 Beckman et al.
20160249916 September 1, 2016 Shelton, IV et al.
20160249917 September 1, 2016 Beckman et al.
20160249918 September 1, 2016 Shelton, IV et al.
20160249919 September 1, 2016 Savage et al.
20160249922 September 1, 2016 Morgan et al.
20160249927 September 1, 2016 Beckman et al.
20160249930 September 1, 2016 Hall et al.
20160249945 September 1, 2016 Shelton, IV et al.
20160256071 September 8, 2016 Shelton, IV et al.
20160256153 September 8, 2016 Shelton, IV et al.
20160256154 September 8, 2016 Shelton, IV et al.
20160256155 September 8, 2016 Shelton, IV et al.
20160256156 September 8, 2016 Shelton, IV et al.
20160256160 September 8, 2016 Shelton, IV et al.
20160256161 September 8, 2016 Overmyer et al.
20160256162 September 8, 2016 Shelton, IV et al.
20160256163 September 8, 2016 Shelton, IV et al.
20160256184 September 8, 2016 Shelton, IV et al.
20160256185 September 8, 2016 Shelton, IV et al.
20160256186 September 8, 2016 Shelton, IV et al.
20160256187 September 8, 2016 Shelton, IV et al.
20160256229 September 8, 2016 Morgan et al.
20160262745 September 15, 2016 Morgan et al.
20160262746 September 15, 2016 Shelton, IV et al.
20160262760 September 15, 2016 Shelton, IV et al.
20160270780 September 22, 2016 Hall et al.
20160287249 October 6, 2016 Alexander, III et al.
20160287250 October 6, 2016 Shelton, IV et al.
20160287251 October 6, 2016 Shelton, IV et al.
20160287253 October 6, 2016 Shelton, IV et al.
20160287254 October 6, 2016 Baxter, III et al.
20160331375 November 17, 2016 Shelton, IV et al.
20170014129 January 19, 2017 Shelton, IV et al.
Foreign Patent Documents
2008207624 March 2009 AU
2010214687 September 2010 AU
2012200178 July 2013 AU
2458946 March 2003 CA
2477181 April 2004 CA
2512960 January 2006 CA
2514274 January 2006 CA
2639177 February 2009 CA
2576347 August 2015 CA
86100996 September 1986 CN
1163558 October 1997 CN
2488482 May 2002 CN
1424891 June 2003 CN
1523725 August 2004 CN
1545154 November 2004 CN
1634601 July 2005 CN
1636525 July 2005 CN
1636526 July 2005 CN
2716900 August 2005 CN
2738962 November 2005 CN
1726874 February 2006 CN
1726878 February 2006 CN
1868411 November 2006 CN
1915180 February 2007 CN
2868212 February 2007 CN
1960679 May 2007 CN
101011286 August 2007 CN
101073509 November 2007 CN
200991269 December 2007 CN
101095621 January 2008 CN
101111196 January 2008 CN
201001747 January 2008 CN
101137402 March 2008 CN
101143105 March 2008 CN
201029899 March 2008 CN
101224122 July 2008 CN
101224124 July 2008 CN
101254126 September 2008 CN
101507620 August 2009 CN
101507622 August 2009 CN
101507623 August 2009 CN
101507625 August 2009 CN
101507628 August 2009 CN
101534724 September 2009 CN
101541251 September 2009 CN
101626731 January 2010 CN
101675898 March 2010 CN
101683280 March 2010 CN
101801284 August 2010 CN
101868203 October 2010 CN
101873834 October 2010 CN
101912285 December 2010 CN
101028205 January 2011 CN
101933824 January 2011 CN
101934098 May 2011 CN
102038531 May 2011 CN
102038532 May 2011 CN
101534722 June 2011 CN
101361666 August 2011 CN
201949071 August 2011 CN
101224119 September 2011 CN
101336835 September 2011 CN
102188270 September 2011 CN
101779977 December 2011 CN
101534723 January 2012 CN
101310680 April 2012 CN
101912284 July 2012 CN
202397539 August 2012 CN
101317782 October 2012 CN
101507639 November 2012 CN
102835977 December 2012 CN
101507633 February 2013 CN
101023879 March 2013 CN
101507624 March 2013 CN
101327137 June 2013 CN
101401736 June 2013 CN
101332110 July 2013 CN
101683281 January 2014 CN
103648408 March 2014 CN
203597997 May 2014 CN
103908313 July 2014 CN
203736251 July 2014 CN
102783741 October 2014 CN
102973300 October 2014 CN
102793571 December 2014 CN
102166129 March 2015 CN
102113902 April 2015 CN
102247177 February 2016 CN
103750872 May 2016 CN
273689 May 1914 DE
1775926 January 1972 DE
3036217 April 1982 DE
3212828 November 1982 DE
3210466 September 1983 DE
3709067 September 1988 DE
4228909 March 1994 DE
9412228 September 1994 DE
19509116 September 1996 DE
19534043 March 1997 DE
19707373 February 1998 DE
19851291 January 2000 DE
19924311 November 2000 DE
69328576 January 2001 DE
20016423 February 2001 DE
10052679 May 2001 DE
20112837 October 2001 DE
20121753 April 2003 DE
10314827 April 2004 DE
10314072 October 2004 DE
202004012389 November 2004 DE
202007003114 June 2007 DE
102010013150 September 2011 DE
0000756 February 1979 EP
0122046 October 1984 EP
0070230 October 1985 EP
0156774 October 1985 EP
0072754 April 1986 EP
0033548 May 1986 EP
0077262 August 1986 EP
0189807 August 1986 EP
0212278 March 1987 EP
0129442 November 1987 EP
0255631 February 1988 EP
0276104 July 1988 EP
0379721 August 1990 EP
0178940 January 1991 EP
0178941 January 1991 EP
0169044 June 1991 EP
0248844 January 1993 EP
0539762 May 1993 EP
0545029 June 1993 EP
0548998 June 1993 EP
0277959 October 1993 EP
0591946 October 1993 EP
0233940 November 1993 EP
0261230 November 1993 EP
0639349 February 1994 EP
0324636 March 1994 EP
0593920 April 1994 EP
0594148 April 1994 EP
0427949 June 1994 EP
0523174 June 1994 EP
0600182 June 1994 EP
0310431 November 1994 EP
0375302 November 1994 EP
0376562 November 1994 EP
0623311 November 1994 EP
0630612 December 1994 EP
0630614 December 1994 EP
0634144 January 1995 EP
0646356 April 1995 EP
0646357 April 1995 EP
0505036 May 1995 EP
0653189 May 1995 EP
0669104 August 1995 EP
0387980 October 1995 EP
0511470 October 1995 EP
0674876 October 1995 EP
0679367 November 1995 EP
0392547 December 1995 EP
0685204 December 1995 EP
0686374 December 1995 EP
0364216 January 1996 EP
0699418 March 1996 EP
0702937 March 1996 EP
0488768 April 1996 EP
0705571 April 1996 EP
0528478 May 1996 EP
0711611 May 1996 EP
0484677 June 1996 EP
0541987 July 1996 EP
0667119 July 1996 EP
0737446 October 1996 EP
0748614 December 1996 EP
0708618 March 1997 EP
0770355 May 1997 EP
0503662 June 1997 EP
0447121 July 1997 EP
0621009 July 1997 EP
0625077 July 1997 EP
0633749 August 1997 EP
0710090 August 1997 EP
0578425 September 1997 EP
0623312 September 1997 EP
0621006 October 1997 EP
0625335 November 1997 EP
0552423 January 1998 EP
0592244 January 1998 EP
0648476 January 1998 EP
0649290 March 1998 EP
0598618 September 1998 EP
0676173 September 1998 EP
0678007 September 1998 EP
0869104 October 1998 EP
0603472 November 1998 EP
0605351 November 1998 EP
0878169 November 1998 EP
0879742 November 1998 EP
0695144 December 1998 EP
0722296 December 1998 EP
0760230 February 1999 EP
0623316 March 1999 EP
0650701 March 1999 EP
0537572 June 1999 EP
0923907 June 1999 EP
0640317 September 1999 EP
0843906 March 2000 EP
0552050 May 2000 EP
0833592 May 2000 EP
0832605 June 2000 EP
0830094 September 2000 EP
1034747 September 2000 EP
1034748 September 2000 EP
0694290 November 2000 EP
1050278 November 2000 EP
1053719 November 2000 EP
1053720 November 2000 EP
1055399 November 2000 EP
1055400 November 2000 EP
1058177 December 2000 EP
1080694 March 2001 EP
1090592 April 2001 EP
1095627 May 2001 EP
0806914 September 2001 EP
0768840 December 2001 EP
0908152 January 2002 EP
0717959 February 2002 EP
0872213 May 2002 EP
0862386 June 2002 EP
0949886 September 2002 EP
1238634 September 2002 EP
0858295 December 2002 EP
0656188 January 2003 EP
0717960 February 2003 EP
1284120 February 2003 EP
1287788 March 2003 EP
0717966 April 2003 EP
0869742 May 2003 EP
0829235 June 2003 EP
0887046 July 2003 EP
1323384 July 2003 EP
0852480 August 2003 EP
0891154 September 2003 EP
0813843 October 2003 EP
0873089 October 2003 EP
0856326 November 2003 EP
1374788 January 2004 EP
0741996 February 2004 EP
0814712 February 2004 EP
1402837 March 2004 EP
0705570 April 2004 EP
0959784 April 2004 EP
1407719 April 2004 EP
1411626 April 2004 EP
1086713 May 2004 EP
0996378 June 2004 EP
1426012 June 2004 EP
0833593 July 2004 EP
1442694 August 2004 EP
0888749 September 2004 EP
0959786 September 2004 EP
1453432 September 2004 EP
1459695 September 2004 EP
1254636 October 2004 EP
1473819 November 2004 EP
1477119 November 2004 EP
1479345 November 2004 EP
1479347 November 2004 EP
1479348 November 2004 EP
0754437 December 2004 EP
1025807 December 2004 EP
1001710 January 2005 EP
1496805 January 2005 EP
1256318 February 2005 EP
1520521 April 2005 EP
1520522 April 2005 EP
1520523 April 2005 EP
1520525 April 2005 EP
1522264 April 2005 EP
1523942 April 2005 EP
1550408 July 2005 EP
1557129 July 2005 EP
1064883 August 2005 EP
1067876 August 2005 EP
0870473 September 2005 EP
1157666 September 2005 EP
0880338 October 2005 EP
1158917 November 2005 EP
1344498 November 2005 EP
0906764 December 2005 EP
1330989 December 2005 EP
0771176 January 2006 EP
1621138 February 2006 EP
1621139 February 2006 EP
1621141 February 2006 EP
1621143 February 2006 EP
1621145 February 2006 EP
1621151 February 2006 EP
1034746 March 2006 EP
1201196 March 2006 EP
1632191 March 2006 EP
1647231 April 2006 EP
1065981 May 2006 EP
1082944 May 2006 EP
1230899 May 2006 EP
1652481 May 2006 EP
1382303 June 2006 EP
1253866 July 2006 EP
1676539 July 2006 EP
1032318 August 2006 EP
1045672 August 2006 EP
1617768 August 2006 EP
1693015 August 2006 EP
1400214 September 2006 EP
1702567 September 2006 EP
1129665 November 2006 EP
1400206 November 2006 EP
1721568 November 2006 EP
1256317 December 2006 EP
1285633 December 2006 EP
1728473 December 2006 EP
1728475 December 2006 EP
1736105 December 2006 EP
1011494 January 2007 EP
1479346 January 2007 EP
1484024 January 2007 EP
1749485 February 2007 EP
1754445 February 2007 EP
1759812 March 2007 EP
1767157 March 2007 EP
1767163 March 2007 EP
1563792 April 2007 EP
1769756 April 2007 EP
1769758 April 2007 EP
1581128 May 2007 EP
1780825 May 2007 EP
1785097 May 2007 EP
1790293 May 2007 EP
1790294 May 2007 EP
1563793 June 2007 EP
1791473 June 2007 EP
1800610 June 2007 EP
1300117 August 2007 EP
1813199 August 2007 EP
1813200 August 2007 EP
1813201 August 2007 EP
1813202 August 2007 EP
1813203 August 2007 EP
1813207 August 2007 EP
1813209 August 2007 EP
1815950 August 2007 EP
1330991 September 2007 EP
1806103 September 2007 EP
1837041 September 2007 EP
0922435 October 2007 EP
1487359 October 2007 EP
1599146 October 2007 EP
1839596 October 2007 EP
2110083 October 2007 EP
1679096 November 2007 EP
1857057 November 2007 EP
1402821 December 2007 EP
1872727 January 2008 EP
1550410 February 2008 EP
1671593 February 2008 EP
1897502 March 2008 EP
1611856 April 2008 EP
1908417 April 2008 EP
1917929 May 2008 EP
1330201 June 2008 EP
1702568 July 2008 EP
1943955 July 2008 EP
1943957 July 2008 EP
1943959 July 2008 EP
1943962 July 2008 EP
1943964 July 2008 EP
1943976 July 2008 EP
1593337 August 2008 EP
1970014 September 2008 EP
1974678 October 2008 EP
1980213 October 2008 EP
1980214 October 2008 EP
1759645 November 2008 EP
1987780 November 2008 EP
1990014 November 2008 EP
1992296 November 2008 EP
1552795 December 2008 EP
1693008 December 2008 EP
1759640 December 2008 EP
1997439 December 2008 EP
2000101 December 2008 EP
2000102 December 2008 EP
2005894 December 2008 EP
2005897 December 2008 EP
2005901 December 2008 EP
2008595 December 2008 EP
2025293 February 2009 EP
1736104 March 2009 EP
1749486 March 2009 EP
1782743 March 2009 EP
2039302 March 2009 EP
2039308 March 2009 EP
2039316 March 2009 EP
1721576 April 2009 EP
1733686 April 2009 EP
2044890 April 2009 EP
2055243 May 2009 EP
1550409 June 2009 EP
1550413 June 2009 EP
1719461 June 2009 EP
1834594 June 2009 EP
1709911 July 2009 EP
2077093 July 2009 EP
1745748 August 2009 EP
2090231 August 2009 EP
2090237 August 2009 EP
2090241 August 2009 EP
2090244 August 2009 EP
2090245 August 2009 EP
2090254 August 2009 EP
2090256 August 2009 EP
2095777 September 2009 EP
2098170 September 2009 EP
2100562 September 2009 EP
2110082 October 2009 EP
2110084 October 2009 EP
2111803 October 2009 EP
1762190 November 2009 EP
1813208 November 2009 EP
1908426 November 2009 EP
2116195 November 2009 EP
2116197 November 2009 EP
1607050 December 2009 EP
1815804 December 2009 EP
1875870 December 2009 EP
1878395 January 2010 EP
2151204 February 2010 EP
1813211 March 2010 EP
2165654 March 2010 EP
2165656 March 2010 EP
2165660 March 2010 EP
2165663 March 2010 EP
2165664 March 2010 EP
1566150 April 2010 EP
1813206 April 2010 EP
2184014 May 2010 EP
1769754 June 2010 EP
1854416 June 2010 EP
1911408 June 2010 EP
2198787 June 2010 EP
2214610 August 2010 EP
2218409 August 2010 EP
1647286 September 2010 EP
1825821 September 2010 EP
1535565 October 2010 EP
1702570 October 2010 EP
1785098 October 2010 EP
2005896 October 2010 EP
2030578 November 2010 EP
2036505 November 2010 EP
2245993 November 2010 EP
2245994 November 2010 EP
2253280 November 2010 EP
1627605 December 2010 EP
2027811 December 2010 EP
2130498 December 2010 EP
2258282 December 2010 EP
2263568 December 2010 EP
1994890 January 2011 EP
2005900 January 2011 EP
2277667 January 2011 EP
2283780 February 2011 EP
2286738 February 2011 EP
1494595 March 2011 EP
1690502 March 2011 EP
1884201 March 2011 EP
2292153 March 2011 EP
1769755 April 2011 EP
2090240 April 2011 EP
2305135 April 2011 EP
2308388 April 2011 EP
2314254 April 2011 EP
2316345 May 2011 EP
2316366 May 2011 EP
2319443 May 2011 EP
2324776 May 2011 EP
1813205 June 2011 EP
2042107 June 2011 EP
2090243 June 2011 EP
2329773 June 2011 EP
2090239 July 2011 EP
2340771 July 2011 EP
2353545 August 2011 EP
2361562 August 2011 EP
2377472 October 2011 EP
1836986 November 2011 EP
1908414 November 2011 EP
2153781 November 2011 EP
2387943 November 2011 EP
2389928 November 2011 EP
1847225 December 2011 EP
2397079 December 2011 EP
2399538 December 2011 EP
1785102 January 2012 EP
1316290 February 2012 EP
2415416 February 2012 EP
2090253 March 2012 EP
2430986 March 2012 EP
1347638 May 2012 EP
1943956 May 2012 EP
2446834 May 2012 EP
2455007 May 2012 EP
2457519 May 2012 EP
2462878 June 2012 EP
2462880 June 2012 EP
1813204 July 2012 EP
2189121 July 2012 EP
2248475 July 2012 EP
2478845 July 2012 EP
2005895 August 2012 EP
2090248 August 2012 EP
2481359 August 2012 EP
2484304 August 2012 EP
2486860 August 2012 EP
2486862 August 2012 EP
2486868 August 2012 EP
1908412 September 2012 EP
1935351 September 2012 EP
2497431 September 2012 EP
1550412 October 2012 EP
1616549 October 2012 EP
2030579 October 2012 EP
2090252 October 2012 EP
2517637 October 2012 EP
2517638 October 2012 EP
2517642 October 2012 EP
2517645 October 2012 EP
2517649 October 2012 EP
2517651 October 2012 EP
2526877 November 2012 EP
2526883 November 2012 EP
1884206 March 2013 EP
2286735 March 2013 EP
2090238 April 2013 EP
2586380 May 2013 EP
2586383 May 2013 EP
2606812 June 2013 EP
2606834 June 2013 EP
1982657 July 2013 EP
2614782 July 2013 EP
2617369 July 2013 EP
2090234 September 2013 EP
2633830 September 2013 EP
2644124 October 2013 EP
2644209 October 2013 EP
2649948 October 2013 EP
2649949 October 2013 EP
1997438 November 2013 EP
2684529 January 2014 EP
2687164 January 2014 EP
2700367 February 2014 EP
2713902 April 2014 EP
1772105 May 2014 EP
2759267 July 2014 EP
2764826 August 2014 EP
2764827 August 2014 EP
2767243 August 2014 EP
2772206 September 2014 EP
2772209 September 2014 EP
2777520 September 2014 EP
2777528 September 2014 EP
2777537 September 2014 EP
2777538 September 2014 EP
2786714 October 2014 EP
2792313 October 2014 EP
2803324 November 2014 EP
2446835 January 2015 EP
2845545 March 2015 EP
1943960 April 2015 EP
2090255 April 2015 EP
2923647 September 2015 EP
2923653 September 2015 EP
2923660 September 2015 EP
2944270 November 2015 EP
1774914 December 2015 EP
2090235 April 2016 EP
2823773 April 2016 EP
2131750 May 2016 EP
2510891 June 2016 EP
1915957 August 2016 EP
2296559 August 2016 EP
2586379 August 2016 EP
2777533 October 2016 EP
2364651 November 2016 EP
2116192 March 2017 EP
2311386 June 2017 EP
2839787 June 2017 EP
2745782 October 2017 EP
2396594 February 2013 ES
459743 November 1913 FR
999646 February 1952 FR
1112936 March 1956 FR
2452275 April 1983 FR
2598905 November 1987 FR
2689749 July 1994 FR
2765794 January 1999 FR
2815842 October 2000 FR
939929 October 1963 GB
1210522 October 1970 GB
1217159 December 1970 GB
1339394 December 1973 GB
2024012 January 1980 GB
2109241 June 1983 GB
2272159 May 1994 GB
2284242 May 1995 GB
2286435 August 1995 GB
2336214 October 1999 GB
2425903 November 2006 GB
2423199 May 2009 GB
2509523 July 2014 GB
930100110 November 1993 GR
S 47-11908 May 1972 JP
S 50-33988 April 1975 JP
S 56-112235 September 1981 JP
S 58500053 January 1983 JP
S 58-501360 August 1983 JP
S 59-174920 March 1984 JP
S 60-100955 June 1985 JP
S 60-212152 October 1985 JP
S 61-98249 May 1986 JP
S 61502036 September 1986 JP
S 62-170011 October 1987 JP
S 63-59764 March 1988 JP
S 63-147449 June 1988 JP
S 63-203149 August 1988 JP
H 02-279149 November 1990 JP
H 03-12126 January 1991 JP
H 03-18354 January 1991 JP
H 03-78514 August 1991 JP
H 03-85009 August 1991 JP
H 04-215747 August 1992 JP
H 04-131860 December 1992 JP
H 05-84252 April 1993 JP
H 05-123325 May 1993 JP
H 06-30945 February 1994 JP
H 06-54857 March 1994 JP
H 06-63054 March 1994 JP
H 06-26812 April 1994 JP
H 06-121798 May 1994 JP
H 06-125913 May 1994 JP
H 06-197901 July 1994 JP
H 06-237937 August 1994 JP
H 06-327684 November 1994 JP
H 07-9622 February 1995 JP
H 07-31623 February 1995 JP
H 07-47070 February 1995 JP
H 07-51273 February 1995 JP
H 07-124166 May 1995 JP
H 07-163573 June 1995 JP
H 07-163574 June 1995 JP
H 07-171163 July 1995 JP
H 07-255735 October 1995 JP
H 07-285089 October 1995 JP
H 07-299074 November 1995 JP
H 08-33641 February 1996 JP
H 08-33642 February 1996 JP
H 08-164141 June 1996 JP
H 08-173437 July 1996 JP
H 08-182684 July 1996 JP
H 08-215201 August 1996 JP
H 08-507708 August 1996 JP
H 08-229050 September 1996 JP
H 08-289895 November 1996 JP
H 08-336540 December 1996 JP
H 08-336544 December 1996 JP
H 09-501081 February 1997 JP
H 09-501577 February 1997 JP
H 09-164144 June 1997 JP
H 10-113352 May 1998 JP
H 10-118090 May 1998 JP
H 10-296660 November 1998 JP
H 10-512465 December 1998 JP
H 10-512469 December 1998 JP
2000-014632 January 2000 JP
2000-033071 February 2000 JP
2000-112002 April 2000 JP
2000-166932 June 2000 JP
2000-171730 June 2000 JP
3056672 June 2000 JP
2000-287987 October 2000 JP
2000-325303 November 2000 JP
2001-037763 February 2001 JP
2001-046384 February 2001 JP
2001-087272 April 2001 JP
2001-514541 September 2001 JP
2001-276091 October 2001 JP
2001-286477 October 2001 JP
2001-517473 October 2001 JP
2002-051974 February 2002 JP
2002-085415 March 2002 JP
2002-143078 May 2002 JP
2002-204801 July 2002 JP
2002-528161 September 2002 JP
2002-314298 October 2002 JP
2002-369820 December 2002 JP
2002-542186 December 2002 JP
2003-000603 January 2003 JP
2003-500153 January 2003 JP
2003-504104 February 2003 JP
2003-135473 May 2003 JP
2003-148903 May 2003 JP
2003-164066 June 2003 JP
2003-521301 July 2003 JP
2003-521304 July 2003 JP
2003-523251 August 2003 JP
2003-523254 August 2003 JP
2003-524431 August 2003 JP
3442423 September 2003 JP
2003-300416 October 2003 JP
2004-147701 May 2004 JP
2004-162035 June 2004 JP
2004-229976 August 2004 JP
2004-524076 August 2004 JP
2004-531280 October 2004 JP
2004-532084 October 2004 JP
2004-532676 October 2004 JP
2004-329624 November 2004 JP
2004-535217 November 2004 JP
2004-337617 December 2004 JP
2004-344662 December 2004 JP
2004-344663 December 2004 JP
2005-013573 January 2005 JP
2005-028147 February 2005 JP
2005-028148 February 2005 JP
2005-028149 February 2005 JP
2005-505309 February 2005 JP
2005-505322 February 2005 JP
2005-505334 February 2005 JP
2005-080702 March 2005 JP
2005-103280 April 2005 JP
2005-103281 April 2005 JP
2005-103293 April 2005 JP
2005-511131 April 2005 JP
2005-511137 April 2005 JP
2005-131163 May 2005 JP
2005-131164 May 2005 JP
2005-131173 May 2005 JP
2005-131211 May 2005 JP
2005-131212 May 2005 JP
2005-137423 June 2005 JP
2005-137919 June 2005 JP
2005-144183 June 2005 JP
2005-152416 June 2005 JP
2005-516714 June 2005 JP
2005-187954 July 2005 JP
2005-521109 July 2005 JP
2005-523105 August 2005 JP
2005-524474 August 2005 JP
4461008 August 2005 JP
2005-296412 October 2005 JP
2005-529675 October 2005 JP
2005-529677 November 2005 JP
2005-328882 December 2005 JP
2005-335432 December 2005 JP
2005-342267 December 2005 JP
2006-034975 February 2006 JP
2006-034977 February 2006 JP
2006-034978 February 2006 JP
2006-034980 February 2006 JP
2006-043451 February 2006 JP
2006-506106 February 2006 JP
2006-510879 March 2006 JP
3791856 June 2006 JP
2006-187649 July 2006 JP
2006-218228 August 2006 JP
2006-218297 August 2006 JP
2006-223872 August 2006 JP
2006-281405 October 2006 JP
2006-289064 October 2006 JP
2006-334412 December 2006 JP
2006-334417 December 2006 JP
2006-346445 December 2006 JP
2007-000634 January 2007 JP
2007-050253 March 2007 JP
2007-061628 March 2007 JP
2007-083051 April 2007 JP
2007-098130 April 2007 JP
2007-105481 April 2007 JP
3906843 April 2007 JP
2007-117725 May 2007 JP
2007-130471 May 2007 JP
2007-130479 May 2007 JP
2007-222615 June 2007 JP
3934161 June 2007 JP
2007-203047 August 2007 JP
2007-203049 August 2007 JP
2007-203051 August 2007 JP
2007-203055 August 2007 JP
2007-203057 August 2007 JP
2007-524435 August 2007 JP
2007-229448 September 2007 JP
2007-526026 September 2007 JP
2007-252916 October 2007 JP
4001860 October 2007 JP
2007-307373 November 2007 JP
2007-325922 December 2007 JP
2008-068073 March 2008 JP
2008-510515 April 2008 JP
2008-516669 May 2008 JP
2008-528203 July 2008 JP
2008-206967 September 2008 JP
2008-212637 September 2008 JP
2008-212638 September 2008 JP
2008-212640 September 2008 JP
2008-220956 September 2008 JP
2008-237881 October 2008 JP
2008-259860 October 2008 JP
2008-264535 November 2008 JP
2008-283459 November 2008 JP
2008-307393 December 2008 JP
2009-000531 January 2009 JP
2009-006137 January 2009 JP
2009-502351 January 2009 JP
2009-502352 January 2009 JP
2009-022742 February 2009 JP
2009-506799 February 2009 JP
2009-507526 February 2009 JP
2009-072595 April 2009 JP
2009-072599 April 2009 JP
2009-090113 April 2009 JP
2009-106752 May 2009 JP
2009-189821 August 2009 JP
2009-189823 August 2009 JP
2009-189836 August 2009 JP
2009-189837 August 2009 JP
2009-189838 August 2009 JP
2009-189846 August 2009 JP
2009-189847 August 2009 JP
2009-201998 September 2009 JP
2009-536082 October 2009 JP
2009-261944 November 2009 JP
2009-268908 November 2009 JP
2009-538684 November 2009 JP
2009-539420 November 2009 JP
2009-291604 December 2009 JP
2010-504808 February 2010 JP
2010-504809 February 2010 JP
2010-504813 February 2010 JP
2010-504846 February 2010 JP
2010-505524 February 2010 JP
2010-069307 April 2010 JP
2010-069310 April 2010 JP
2010-075694 April 2010 JP
2010-075695 April 2010 JP
2010-088876 April 2010 JP
2010-094514 April 2010 JP
2010-098844 April 2010 JP
2010-520025 June 2010 JP
2010-142636 July 2010 JP
2010-148879 July 2010 JP
2010-214166 September 2010 JP
4549018 September 2010 JP
2010-240411 October 2010 JP
2010-240429 October 2010 JP
2010-246948 November 2010 JP
2010-279690 December 2010 JP
2010-540041 December 2010 JP
2010-540192 December 2010 JP
2011-005260 January 2011 JP
2011-504391 February 2011 JP
2011-509786 March 2011 JP
2011-072797 April 2011 JP
2011-078763 April 2011 JP
2011-115594 June 2011 JP
2011-520564 July 2011 JP
2011-524199 September 2011 JP
4783373 September 2011 JP
2011-251156 December 2011 JP
2012-040398 March 2012 JP
2012-507356 March 2012 JP
2012-517289 August 2012 JP
5140421 February 2013 JP
5162595 March 2013 JP
2013-517891 May 2013 JP
2013-526342 June 2013 JP
2013-128791 July 2013 JP
5212039 July 2013 JP
5333899 November 2013 JP
6007357 October 2016 JP
20110003229 January 2011 KR
1814161 May 1993 RU
2008830 March 1994 RU
2052979 January 1996 RU
2066128 September 1996 RU
2098025 December 1997 RU
2141279 November 1999 RU
2144791 January 2000 RU
2181566 April 2002 RU
2187249 August 2002 RU
2189091 September 2002 RU
32984 October 2003 RU
2225170 March 2004 RU
42750 December 2004 RU
61114 February 2007 RU
2007-103563 August 2008 RU
189517 January 1967 SU
328636 September 1972 SU
511939 April 1976 SU
674747 July 1979 SU
886900 December 1981 SU
1009439 April 1983 SU
1022703 June 1983 SU
1271497 November 1986 SU
1333319 August 1987 SU
1377053 February 1988 SU
1443874 December 1988 SU
1509051 September 1989 SU
1561964 May 1990 SU
1708312 January 1992 SU
1722476 March 1992 SU
1752361 August 1992 SU
WO 82/02824 September 1982 WO
WO 86/02254 April 1986 WO
WO 91/15157 October 1991 WO
WO 92/20295 November 1992 WO
WO 92/21300 December 1992 WO
WO 93/08755 May 1993 WO
WO 93/13718 July 1993 WO
WO 93/14690 August 1993 WO
WO 93/15648 August 1993 WO
WO 93/15850 August 1993 WO
WO 93/19681 October 1993 WO
WO 94/00060 January 1994 WO
WO 94/11057 May 1994 WO
WO 94/12108 June 1994 WO
WO 94/14129 June 1994 WO
WO 94/17737 August 1994 WO
WO 94/18893 September 1994 WO
WO 94/20030 September 1994 WO
WO 94/22378 October 1994 WO
WO 94/23659 October 1994 WO
WO 94/24943 November 1994 WO
WO 94/24947 November 1994 WO
WO 95/02369 January 1995 WO
WO 95/03743 February 1995 WO
WO 95/06817 March 1995 WO
WO 95/09576 April 1995 WO
WO 95/09577 April 1995 WO
WO 95/14436 June 1995 WO
WO 95/17855 July 1995 WO
WO 95/18383 July 1995 WO
WO 95/18572 July 1995 WO
WO 95/19739 July 1995 WO
WO 95/20360 August 1995 WO
WO 95/23557 September 1995 WO
WO 95/24865 September 1995 WO
WO 95/25471 September 1995 WO
WO 95/26562 October 1995 WO
WO 95/29639 November 1995 WO
WO 96/04858 February 1996 WO
WO 96/18344 June 1996 WO
WO 96/19151 June 1996 WO
WO 96/19152 June 1996 WO
WO 96/20652 July 1996 WO
WO 96/21119 July 1996 WO
WO 96/22055 July 1996 WO
WO 96/23448 August 1996 WO
WO 96/24301 August 1996 WO
WO 96/27337 September 1996 WO
WO 96/31155 October 1996 WO
WO 96/35464 November 1996 WO
WO 96/39085 December 1996 WO
WO 96/39086 December 1996 WO
WO 96/39087 December 1996 WO
WO 96/39088 December 1996 WO
WO 96/39089 December 1996 WO
WO 97/00646 January 1997 WO
WO 97/00647 January 1997 WO
WO 97/01989 January 1997 WO
WO 97/06582 February 1997 WO
WO 97/10763 March 1997 WO
WO 97/10764 March 1997 WO
WO 97/11648 April 1997 WO
WO 97/11649 April 1997 WO
WO 97/15237 May 1997 WO
WO 97/24073 July 1997 WO
WO 97/24993 July 1997 WO
WO 97/30644 August 1997 WO
WO 97/30659 August 1997 WO
WO 97/34533 September 1997 WO
WO 97/37598 October 1997 WO
WO 97/39688 October 1997 WO
WO 97/41767 November 1997 WO
WO 98/01080 January 1998 WO
WO 98/17180 April 1998 WO
WO 98/22154 May 1998 WO
WO 98/27880 July 1998 WO
WO 98/30153 July 1998 WO
WO 98/47436 October 1998 WO
WO 98/58589 December 1998 WO
WO 99/02090 January 1999 WO
WO 99/03407 January 1999 WO
WO 99/03408 January 1999 WO
WO 99/03409 January 1999 WO
WO 99/12483 March 1999 WO
WO 99/12487 March 1999 WO
WO 99/12488 March 1999 WO
WO 99/15086 April 1999 WO
WO 99/15091 April 1999 WO
WO 99/23933 May 1999 WO
WO 99/23959 May 1999 WO
WO 99/25261 May 1999 WO
WO 99/29244 June 1999 WO
WO 99/34744 July 1999 WO
WO 99/45849 September 1999 WO
WO 99/48430 September 1999 WO
WO 99/51158 October 1999 WO
WO 00/24322 May 2000 WO
WO 00/24330 May 2000 WO
WO 00/33755 June 2000 WO
WO 00/41638 July 2000 WO
WO 00/48506 August 2000 WO
WO 00/53112 September 2000 WO
WO 00/54653 September 2000 WO
WO 00/057796 October 2000 WO
WO 00/64365 November 2000 WO
WO 00/72762 December 2000 WO
WO 00/72765 December 2000 WO
WO 00/78222 December 2000 WO
WO 01/03587 January 2001 WO
WO 01/05702 January 2001 WO
WO 01/010482 February 2001 WO
WO 01/35845 May 2001 WO
WO 01/54594 August 2001 WO
WO 01/58371 August 2001 WO
WO 01/62158 August 2001 WO
WO 01/62161 August 2001 WO
WO 01/62162 August 2001 WO
WO 01/62163 August 2001 WO
WO 01/62164 August 2001 WO
WO 01/62169 August 2001 WO
WO 01/78605 October 2001 WO
WO 01/80757 November 2001 WO
WO 01/91646 December 2001 WO
WO 02/00121 January 2002 WO
WO 02/07608 January 2002 WO
WO 02/07618 January 2002 WO
WO 02/17799 March 2002 WO
WO 02/19920 March 2002 WO
WO 02/19932 March 2002 WO
WO 02/26143 April 2002 WO
WO 02/30297 April 2002 WO
WO 02/32322 April 2002 WO
WO 02/36028 May 2002 WO
WO 02/43571 June 2002 WO
WO 02/058568 August 2002 WO
WO 02/060328 August 2002 WO
WO 02/065933 August 2002 WO
WO 02/067785 September 2002 WO
WO 02/080781 October 2002 WO
WO 02/085218 October 2002 WO
WO 02/087586 November 2002 WO
WO 02/098302 December 2002 WO
WO 03/000138 January 2003 WO
WO 03/001329 January 2003 WO
WO 03/001986 January 2003 WO
WO 03/013363 February 2003 WO
WO 03/013372 February 2003 WO
WO 03/015604 February 2003 WO
WO 03/020106 March 2003 WO
WO 03/020139 March 2003 WO
WO 03/024339 March 2003 WO
WO 2003/079909 March 2003 WO
WO 03/030743 April 2003 WO
WO 03/037193 May 2003 WO
WO 2003/047436 June 2003 WO
WO 03/055402 July 2003 WO
WO 03/057048 July 2003 WO
WO 03/057058 July 2003 WO
WO 2003/063694 August 2003 WO
WO 03/077769 September 2003 WO
WO 03/079911 October 2003 WO
WO 03/082126 October 2003 WO
WO 03/086206 October 2003 WO
WO 03/088845 October 2003 WO
WO 03/090630 November 2003 WO
WO 03/094743 November 2003 WO
WO 03/094745 November 2003 WO
WO 2003/094746 November 2003 WO
WO 2003/094747 November 2003 WO
WO 03/101313 December 2003 WO
WO 03/105698 December 2003 WO
WO 03/105702 December 2003 WO
WO 2004/004578 January 2004 WO
WO 2004/006980 January 2004 WO
WO 2004/011037 February 2004 WO
WO 2004/014238 February 2004 WO
WO 2004/019769 March 2004 WO
WO 2004/019803 March 2004 WO
WO 2004/021868 March 2004 WO
WO 2004/028585 April 2004 WO
WO 2004/030554 April 2004 WO
WO 2004/032754 April 2004 WO
WO 2004/032760 April 2004 WO
WO 2004/032762 April 2004 WO
WO 2004/032763 April 2004 WO
WO 2004/032783 April 2004 WO
WO 2004/034875 April 2004 WO
WO 2004/047626 June 2004 WO
WO 2004/047653 June 2004 WO
WO 2004/049956 June 2004 WO
WO 2004/050971 June 2004 WO
WO 2004/052426 June 2004 WO
WO 2004/056276 July 2004 WO
WO 2004/056277 July 2004 WO
WO 2004/062516 July 2004 WO
WO 2004/064600 August 2004 WO
WO 2004/078050 September 2004 WO
WO 2004/078051 September 2004 WO
WO 2004/078236 September 2004 WO
WO 2004/086987 October 2004 WO
WO 2004/096015 November 2004 WO
WO 2004/096057 November 2004 WO
WO 2004/103157 December 2004 WO
WO 2004/105593 December 2004 WO
WO 2004/105621 December 2004 WO
WO 2004/112618 December 2004 WO
WO 2004/112652 December 2004 WO
WO 2005/027983 March 2005 WO
WO 2005/037329 April 2005 WO
WO 2005/042041 May 2005 WO
WO 2005/044078 May 2005 WO
WO 2005/048809 June 2005 WO
WO 2005/055846 June 2005 WO
WO 2005/072634 August 2005 WO
WO 2005/078892 August 2005 WO
WO 2005/079675 September 2005 WO
WO 2005/087128 September 2005 WO
WO 2005/096954 October 2005 WO
WO 2005/110243 November 2005 WO
WO 2005/112806 December 2005 WO
WO 2005/112808 December 2005 WO
WO 2005/115251 December 2005 WO
WO 2005/115253 December 2005 WO
WO 2005/117735 December 2005 WO
WO 2005/122936 December 2005 WO
WO 2006/023486 March 2006 WO
WO 2006/023578 March 2006 WO
WO 2006/026520 March 2006 WO
WO 2006/027014 March 2006 WO
WO 2006/028314 March 2006 WO
WO 2006/044490 April 2006 WO
WO 2006/044581 April 2006 WO
WO 2006/044810 April 2006 WO
WO 2006/049852 May 2006 WO
WO 2006/050360 May 2006 WO
WO 2006/051252 May 2006 WO
WO 2006/057702 June 2006 WO
WO 2006/059067 June 2006 WO
WO 2006/073581 July 2006 WO
WO 2006/083748 August 2006 WO
WO 2006/085389 August 2006 WO
WO 2006/092563 September 2006 WO
WO 2006/092565 September 2006 WO
WO 2006/115958 November 2006 WO
WO 2006/125940 November 2006 WO
WO 2006/132992 December 2006 WO
WO 2007/002180 January 2007 WO
WO 2007/016290 February 2007 WO
WO 2007/018898 February 2007 WO
WO 2007/034161 March 2007 WO
WO 2007/051000 May 2007 WO
WO 2007/059233 May 2007 WO
WO 2007/074430 July 2007 WO
WO 2007/089603 August 2007 WO
WO 2007/098220 August 2007 WO
WO 2007/121579 November 2007 WO
WO 2007/129121 November 2007 WO
WO 2007/131110 November 2007 WO
WO 2007/137304 November 2007 WO
WO 2007/139734 December 2007 WO
WO 2007/142625 December 2007 WO
WO 2007/145825 December 2007 WO
WO 2007/146987 December 2007 WO
WO 2007/147439 December 2007 WO
WO 2008/020964 February 2008 WO
WO 2008/021687 February 2008 WO
WO 2008/021969 February 2008 WO
WO 2008/027972 March 2008 WO
WO 2008/039237 April 2008 WO
WO 2008/039249 April 2008 WO
WO 2008/039270 April 2008 WO
WO 2008/045383 April 2008 WO
WO 2008/057281 May 2008 WO
WO 2008/070763 June 2008 WO
WO 2008/080148 July 2008 WO
WO 2008/089404 July 2008 WO
WO 2008/101080 August 2008 WO
WO 2008/101228 August 2008 WO
WO 2008/103797 August 2008 WO
WO 2008/109123 September 2008 WO
WO 2008/109125 September 2008 WO
WO 2008/112912 September 2008 WO
WO 2008/118728 October 2008 WO
WO 2008/118928 October 2008 WO
WO 2008/124748 October 2008 WO
WO 2008/131357 October 2008 WO
WO 2009/005969 January 2009 WO
WO 2009/022614 February 2009 WO
WO 2009/023851 February 2009 WO
WO 2009/033057 March 2009 WO
WO 2009/039506 March 2009 WO
WO 2009/046394 April 2009 WO
WO 2009/066105 May 2009 WO
WO 2009/067649 May 2009 WO
WO 2009/091497 July 2009 WO
WO 2009/120944 October 2009 WO
WO 2009/137761 November 2009 WO
WO 2009/143092 November 2009 WO
WO 2009/143331 November 2009 WO
WO 2009/150650 December 2009 WO
WO 2009/152307 December 2009 WO
WO 2010/028332 March 2010 WO
WO 2010/030434 March 2010 WO
WO 2010/045425 April 2010 WO
WO 2010/050771 May 2010 WO
WO 2010/054404 May 2010 WO
WO 2010/056714 May 2010 WO
WO 2010/063795 June 2010 WO
WO 2010/090940 August 2010 WO
WO 2010/093333 August 2010 WO
WO 2010/098871 September 2010 WO
WO 2011/008672 January 2011 WO
WO 2011/013103 February 2011 WO
WO 2011/044343 April 2011 WO
WO 2011/060311 May 2011 WO
WO 2011/084969 July 2011 WO
WO 2011/127137 October 2011 WO
WO 2012/006306 January 2012 WO
WO 2012/009431 January 2012 WO
WO 2012/021671 February 2012 WO
WO 2012/040438 March 2012 WO
WO 2012/044551 April 2012 WO
WO 2012/044554 April 2012 WO
WO 2012/044597 April 2012 WO
WO 2012/044606 April 2012 WO
WO 2012/044820 April 2012 WO
WO 2012/044844 April 2012 WO
WO 2012/044853 April 2012 WO
WO 2012/044854 April 2012 WO
WO 2012/058213 May 2012 WO
WO 2012/068156 May 2012 WO
WO 2012/109760 August 2012 WO
WO 2012/127462 September 2012 WO
WO 2012/135705 October 2012 WO
WO 2012/143913 October 2012 WO
WO 2012/148667 November 2012 WO
WO 2012/148668 November 2012 WO
WO 2012/148703 November 2012 WO
WO 2012/160163 November 2012 WO
WO 2012/166503 December 2012 WO
WO 2013/009252 January 2013 WO
WO 2013/009699 January 2013 WO
WO 2013/023114 February 2013 WO
WO 2013/036409 March 2013 WO
WO 2013/043707 March 2013 WO
WO 2013/043717 March 2013 WO
WO 2013/043721 March 2013 WO
WO 2013/062978 May 2013 WO
WO 2013/116869 August 2013 WO
WO 2013/148762 October 2013 WO
WO 2013/167427 November 2013 WO
WO 2013/188130 December 2013 WO
WO 2014/004199 January 2014 WO
WO 2014/004294 January 2014 WO
WO 2014/008289 January 2014 WO
WO 2014/134034 September 2014 WO
WO 2014/172213 October 2014 WO
WO 2015/032797 March 2015 WO
WO 2015/148136 October 2015 WO
WO 2015/148141 October 2015 WO
WO 2015/153642 October 2015 WO
WO 2007/014355 February 2017 WO
Other references
  • ASTM procedure D2240-00, “Standard Test Method for Rubber Property-Durometer Hardness,” (Published Aug. 2000).
  • ASTM procedure D2240-05, “Standard Test Method for Rubber Property-Durometer Hardness,” (Published Apr. 2010).
  • Disclosed Anonymously, “Motor-Driven Surgical Stapler Improvements,” Research Disclosure Database No. 526041, Published: Feb. 2008.
  • C.C. Thompson et al., “Peroral Endoscopic Reduction of Dilated Gastrojejunal Anastomosis After Roux-en-Y Gastric Bypass: A Possible New Option for Patients with Weight Regain,” Surg Endosc (2006) vol. 20, pp. 1744-1748.
  • B.R. Coolman, DVM, MS et al., “Comparison of Skin Staples With Sutures for Anastomosis of the Small Intestine in Dogs,” Abstract; http://www.blackwell-synergy.com/doi/abs/10.1053/jvet.2000.7539?cookieSet=1&journalCode=vsu which redirects to http://www3.interscience.wiley.com/journal/119040681/abstract?CRETRY=1&SRETRY=0; [online] accessed: Sep. 22, 2008 (2 pages).
  • The Sodem Aseptic Battery Transfer Kit, Sodem Systems, (2000), 3 pages.
  • “Biomedical Coatings,” Fort Wayne Metals, Research Products Corporation, obtained online at www.fwmetals.com on Jun. 21, 2010 (1 page).
  • Van Meer et al., “A Disposable Plastic Compact Wrist for Smart Minimally Invasive Surgical Tools,” LAAS/CNRS (Aug. 2005).
  • Breedveld et al., “A New, Easily Miniaturized Sterrable Endoscope,” IEEE Engineering in Medicine and Biology Magazine (Nov./Dec. 2005).
  • D. Tuite, Ed., “Get the Lowdown on Ultracapacitors,” Nov. 15, 2007; [online] URL: http://electronicdesign.com/Articles/Print.cfm?ArticleID=17465, accessed Jan. 15, 2008 (5 pages).
  • Datasheet for Panasonic TK Relays Ultra Low Profile 2 A Polarized Relay, Copyright Matsushita Electric Works, Ltd. (Known of at least as early as Aug. 17, 2010), 5 pages.
  • Covidien Brochure, “Endo GIA™ Reloads with Tri-Staple™ Technology,” (2010), 1 page.
  • Covidien Brochure, “Endo GIA™ Reloads with Tri-Staple™ Technology and Endo GIA™ Ultra Universal Staplers,” (2010), 2 pages.
  • Covidien Brochure, “Endo GIA™ Black Reload with Tri-Staple™ Technology,” (2012), 2 pages.
  • Covidien Brochure, “Endo GIA™ Curved Tip Reload with Tri-Staple™ Technology,” (2012), 2 pages.
  • Covidien Brochure, “Endo GIA™ Reloads with Tri-Staple™ Technology,” (2010), 2 pages.
  • Covidien Brochure, “Endo GIA™ Ultra Universal Stapler,” (2010), 2 pages.
  • Miyata et al., “Biomolecule-Sensitive Hydrogels,” Advanced Drug Delivery Reviews, 54 (2002) pp. 79-98.
  • Jeong et al., “Thermosensitive Sol-Gel Reversible Hydrogels,” Advanced Drug Delivery Reviews, 54 (2002) pp. 37-51.
  • Byrne et al., “Molecular Imprinting Within Hydrogels,” Advanced Drug Delivery Reviews, 54 (2002) pp. 149-161.
  • Qiu et al., “Environment-Sensitive Hydrogels for Drug Delivery,” Advanced Drug Delivery Reviews, 53 (2001) pp. 321-339.
  • Hoffman, “Hydrogels for Biomedical Applications,” Advanced Drug Delivery Reviews, 43 (2002) pp. 3-12.
  • Hoffman, “Hydrogels for Biomedical Applications,” Advanced Drug Delivery Reviews, 54 (2002) pp. 3-12.
  • Peppas, “Physiologically Responsive Hydrogels,” Journal of Bioactive and Compatible Polymers, vol. 6 (Jul. 1991) pp. 241-246.
  • Ebara, “Carbohydrate-Derived Hydrogels and Microgels,” Engineered Carbohydrate-Based Materials for Biomedical Applications: Polymers, Surfaes, Dendrimers, Nanoparticles, and Hydrogels, Edited by Ravin Narain, 2011, pp. 337-345.
  • Peppas, Editor “Hydrogels in Medicine and Pharmacy,” vol. I, Fundamentals, CRC Press, 1986.
  • Matsuda, “Thermodynamics of Formation of Porous Polymeric Membrane from Solutions,” Polymer Journal, vol. 23, No. 5, pp. 435-444 (1991).
  • Young, “Microcellular foams via phase separation,” Journal of Vacuum Science & Technology A 4(3), (May/Jun. 1986).
  • Chen et al., “Elastomeric Biomaterials for Tissue Engineering,” Progress in Polymer Science 38 (2013), pp. 584-671.
  • Pitt et al., “Attachment of Hyaluronan to Metallic Surfaces,” J. Biomed. Mater. Res. 68A: pp. 95-106, 2004.
  • Schellhammer et al., “Poly-Lactic-Acid for Coating of Endovascular Stents: Preliminary Results in Canine Experimental Av-Fistulae,” Mat.-wiss. u. Werkstofftech., 32, pp. 193-199 (2001).
  • Solorio et al., “Gelatin Microspheres Crosslinked with Genipin for Local Delivery of Growth Factors,” J. Tissue Eng. Regen. Med. (2010), 4(7): pp. 514-523.
  • http://ninpgan.net/publications/51-100/89.pdf; 2004, Ning Pan, On Uniqueness of Fibrous Materials, Design & Nature II. Eds: Colins, M. and Brebbia, C. WIT Press, Boston, 493-504.
  • Covidien iDrive™ Ultra in Service Reference Card, “iDrive™ Ultra Powered Stapling Device,” (4 pages).
  • Covidien iDrive™ Ultra Powered Stapling System ibrochure, “The Power of iDrive™ Ultra Powered Stapling System and Tri-Staple™ Technology,” (23 pages).
  • Seils et al., Covidien Summary: Clinical Study “UCONN Biodynamics: Final Report on Results,” (2 pages).
  • Covidien “iDrive™ Ultra Powered Stapling System, A Guide for Surgeons,” (6 pages).
  • Covidien “iDrive™ Ultra Powered Stapling System, Cleaning and Sterilization Guide,” (2 pages).
  • Covidien brochure “iDriven™ Ultra Powered Stapling System,” (6 pages).
  • “Indian Standard: Automotive Vehicles—Brakes and Braking Systems (IS 11852-1:2001)”, Mar. 1, 2001.
  • Fast, Versatile Blackfin Processors Handle Advanced RFID Reader Applications; Analog Dialogue: vol. 40—Sep. 2006; http://www.analog.com/library/analogDialogue/archives/40-09/rfid.pdf; Wayback Machine to Feb. 15, 2012.
  • Serial Communication Protocol; Michael Lemmon Feb. 1, 2009; http://www3.nd.edu/˜lemmon/courses/ee224/web-manual/web-manual/lab12/node2.html; Wayback Machine to Apr. 29, 2012.
  • Allegro MicroSystems, LLC, Automotive Full Bridge MOSFET Driver, A3941-DS, Rev. 5, 21 pages, http://www.allegromicro.com/˜/media/Files/Datasheets/A3941-Datasheet.ashx?la=en.
  • Patrick J. Sweeney: “RFID for Dummies”, Mar. 11, 2010, pp. 365-365, XP055150775, ISBN: 978-1-11-805447-5, Retrieved from the Internet: URL: books.google.de/books?isbn=1118054474 [retrieved on Nov. 4, 2014]—book not attached.
  • Data Sheet of LM4F230H5QR, 2007.
  • Cuper et al., “The Use of Near-Infrared Light for Safe and Effective Visualization of Subsurface Blood Vessels to Facilitate Blood Withdrawal in Children,” Medical Engineering & Physics, vol. 35, No. 4, pp. 433-440 (2013).
Patent History
Patent number: 10064624
Type: Grant
Filed: Nov 20, 2014
Date of Patent: Sep 4, 2018
Patent Publication Number: 20150136835
Assignee: Ethicon LLC (Guaynabo, PR)
Inventors: Frederick E. Shelton, IV (Hillsboro, OH), Joseph E. Young (Loveland, OH), Taylor W. Aronhalt (Loveland, OH), Chester O. Baxter, III (Loveland, OH)
Primary Examiner: Nathaniel Chukwurah
Application Number: 14/549,219
Classifications
Current U.S. Class: Material Placed On Opposed Sides Of Incision Or Wound (606/215)
International Classification: A61B 17/10 (20060101); A61B 17/068 (20060101); A61B 17/3209 (20060101); A61B 17/072 (20060101); A61B 17/00 (20060101); A61B 17/29 (20060101); A61B 90/00 (20160101);